‘Widespread And Systemic Failures’ Cited In Cigna Medicare Advantage Suspension
The Centers for Medicare & Medicaid Services said Cigna did not handle complaints and grievances from patients properly. The suspension will not affect those already enrolled.
The Wall Street Journal: Cigna Faces Halt In Medicare Advantage Enrollment Cigna Corp. said Friday that enrollment into its Medicare Advantage and prescription-drug plans has been halted by the government, posing a challenge to the insurer as it aims to wind up its acquisition by Anthem Inc. In a letter to Cigna, the Centers for Medicare and Medicaid Services said it imposed the sanctions because of problems with the insurer’s coverage-appeals process, among other issues, and the agency cited a “longstanding history of noncompliance” with requirements. Connecticut-based Cigna was also blocked as of 11:59 p.m. EST Thursday from marketing its Medicare plans. (Wilde Mathews, 1/22)
Reuters: U.S. Government Suspends Enrollment In Cigna Medicare Advantage The U.S. government has suspended new enrollment in Cigna Corp’s Medicare Advantage health insurance and prescription drug plans, saying Cigna had “widespread and systemic failures” that prevented patients from accessing medical services. The government said Cigna did not handle complaints and grievances properly from patients who had been denied coverage for health benefits or drugs, according to a Jan. 21 letter from its regulator, the Centers for Medicare and Medicaid. (Humer, 1/22)
USA Today: Cigna Temporarily Banned From New Medicare Plans U.S. regulators have temporarily banned health insurer Cigna from offering certain Medicare plans to new patients after a probe uncovered issues with current offerings. … The sanctions, which took effect at the end of the day Thursday, do not affect patients who are already enrolled. CMS said could not provide an estimate for how many patients were affected. (Bomey, 1/22)
In other news on Medicare Advantage, a new study looks at CMS’s cost predictions —
Morning Consult: Report: CMS $2.6 Bln Off For Some Medicare Advantage Costs The Centers for Medicare and Medicaid Services under-predicts costs for Medicare Advantage patients with multiple chronic illnesses by about $2.6 billion annually, according to a study by Avalere Health. The report, published today and funded by the lobbying group America’s Health Insurance Plans, suggested Medicare Advantage’s risk-adjustment model is to blame for the cost discrepancies. (McIntire, 1/22)
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.