On October 29th, 2014, Chinese Community Health Plan (CCHP) was notified that they were being put on immediate imposition of intermediate sanctions from the Centers for Medicare & Medicaid Services (CMS). The Medicare sanction was triggered by what the CMS auditors concluded were severe violations in the Chinese Community Health Plan Medicare Advantage (MA-PD) plans offered in […]
Sanctions
Posts related to sanctions imposed by the Center for Medicare and Medicaid Services on Medicare Advantage plans.
Medicare sanctions CalOptima’s OneCare Special Needs Plan
Orange County Health Authority’s CalOptima OneCare Medicare Advantage plan was served a notice of immediate sanctions by the Centers for Medicare and Medicaid Services (CMS) on January 24, 2014. The immediate sanctions mean that CalOptima can’t market or enroll new members into their OneCare Special Needs Plan until the sanctions are lifted. CMS cited “widespread and systemic failures impacting CalOptima’s enrollees’ ability to access health care services and prescription medications” as a summary for issuing immediate sanctions.
CMS sanctions SmartD Rx PDP
CMS cited numerous failures on the part of SmartD Rx to properly handle member’s prescription drug and enrollment transactions.