Government orders three Medicare advantage plans to stop marketing, enrolling new members

The Wall Street Journal / Dow Jones Newswires: "The U.S. government's Medicare program has ordered three health insurers -- Universal American Corp. (UAM), Health Net Inc. (HNT) and Arcadian Health -- to stop marketing to and enrolling new members in their Medicare Advantage health and prescription-drug plans, saying the companies violated regulations. The moves come at a critical time, the midst of the 2011 Medicare open-enrollment season, when seniors choose their plans for Medicare health and drug coverage for next year. Open enrollment runs from Nov. 15 through Dec. 31. While seniors can select the traditional, government-run Medicare program, insurance companies offer government-funded Medicare Advantage plans that operate like a health maintenance organization or a preferred provider organization" (Wisenberg Brin and Kingsbury, 11/22).

Stockton (Calif.) Record: "These sanctions will remain in effect until each of the three plans demonstrates to CMS that it has corrected the related deficiencies and that those deficiencies are not likely to recur. The actions will not impact the 1 million Medicare beneficiaries enrolled in these health and drug plans" (11/23).

The Associated Press/Bloomberg Businessweek: "Health insurer Universal American Corp. said Monday federal regulators will suspend the company from enrolling new members in its Medicare Advantage plans as an open-enrollment period for the government-subsidized health coverage gets under way. The Rye Brook, N.Y., company said the suspension by the Centers for Medicare and Medicaid Services starts Dec. 5 and is tied mainly [to] agent oversight and market conduct issues. It said it was 'working diligently' to resolve the issues as soon as possible" (11/22).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.