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MN073 CMS Releases Sanctions on Cigna Medicare Plans

MN073 CMS Releases Sanctions on Cigna Medicare Plans

FromMedicare Nation


MN073 CMS Releases Sanctions on Cigna Medicare Plans

FromMedicare Nation

ratings:
Length:
34 minutes
Released:
Jun 19, 2017
Format:
Podcast episode

Description

Hey Medicare Nation! I'm so happy to be here and tell you the latest, regarding Cigna-HealthSpring (Cigna) Medicare Advantage Prescription Drug Plans (MAPD) and Prescription Drug Plans (PDP). In January of 2016, CMS suspended Cigna from enrolling NEW Medicare Beneficiaries into their Medicare Advantage and stand-alone Prescription Drug Plans. The following States were affected by the suspension: Alabama, Arizona, Florida, Georgia, North Carolina, Pennsylvania, South Carolina and Tennesse. ON June 16, 2017, CMS released the suspension of marketing and enrollment sanctions on Cigna.....with a big BUT. On March 17, 2017, CMS received an attestation from Cigna, stating Cigna had corrected all  the violations that were listed in the CMS sanction notice. Quoted from the letter CMS sent to Cigna interim CEO & COO Mr. Shawn Moore - "CMS required Cigna to hire an independent auditor to conduct a validation audit provide CMS with the results of the audit. CMS used the information in the audit report to determine whether Cigna corrected the deficiencies that formed the basis for the sanction." Based on the results of the audit report, CMS determined that......"Cigna's deficiencies have been sufficiently corrected." Therefore, effective June 16, 2017, CMS is lifting the intermediate sanctions for Cigna's contracts and Cigna will return to normal marketing and enrollment status." Further down in the CMS document, on page 2, paragraph 1, line 3, it states...."In addition, during the independent validation audit, several findings were indentified, none of which prevent CMS from releasing Cigna from sanctions, but some of which merit additional monitoring and reporting. .......For up to one year, CMS will also conduct targeted monitoring in certain areas to ensure that Cigna continues to improve its operations.  What does that mean if you are currently a Medicare beneficiary on a Cigna-HealthSpring MAPD or PDP Plan? First of all, you are completely covered. Your benefits are intact and current. What you need to do now is become more "diligent" in reviewing your "explanation of benefits" (EOB) statement. Your EOB statement will contain information regarding prescription drugs, medical visits, diagnostics etc.  You should be ensuring the prescriptions listed on your EOB are the ones you received and that each doctor, diagnostic tests & procedures, hospitalizations etc. were actually done! Mistakes happen more than you know. Human errors and computer errors happen frequently. When you look at your EOB Statement every month you help eliminate these errors.  It is soooo important to review your EOB statement each month. If you find an error on your EOB statement, you have several options to rectify it. #1. Call Cigna Customer Support (800-668-3813)        Explain to customer support the "discrepency" you          found on your EOB statement. That may easily              correct the issue you found.  #2. Call your Medicare Consultant, Medicare                  Advisor or Agent.        Your Medicare Agent, who "sold" you this             policy, should be available to assist you with questions  or issues with your Cigna plan. #3. Contact Senior Medicare Patrol        Go to the Senior Medicare Patrol website to look up resources in your area.         Senior Medicare Patrol #4.  Contact your State Dept. of Aging          Every State has a Department of Aging or Department of Elder Affairs, which will assist you with many types of issues.          The "Healthy Aging" website has a list of each State's contact information for their Department of Aging or Elder Affairs.            Here's the link:           Healthy Aging List of State Agencies #5.   Contact Medicare          As a last resort, call Medicare directly. Government "downsizing" has caused delays in telephone correspondence, but it is still a reliable source.          Expect to be on hold from ten minutes to an hour, depending on the day and season.   Expect to see Cigna hit the airwaves and y
Released:
Jun 19, 2017
Format:
Podcast episode

Titles in the series (100)

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