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CMS Hands Out Civil Money Penalties To 3 More Medicare Plans

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When? This feed was archived on May 25, 2022 08:29 (2y ago). Last successful fetch was on July 19, 2020 18:35 (3+ y ago)

Why? 無効なフィード status. サーバーは持続期間に有効なポッドキャストのフィードを取得することができませんでした。

What now? You might be able to find a more up-to-date version using the search function. This series will no longer be checked for updates. If you believe this to be in error, please check if the publisher's feed link below is valid and contact support to request the feed be restored or if you have any other concerns about this.

Manage episode 267635136 series 1093150
コンテンツは Diane Daniels によって提供されます。エピソード、グラフィック、ポッドキャストの説明を含むすべてのポッドキャスト コンテンツは、Diane Daniels またはそのポッドキャスト プラットフォーム パートナーによって直接アップロードされ、提供されます。誰かがあなたの著作権で保護された作品をあなたの許可なく使用していると思われる場合は、ここで概説されているプロセスに従うことができますhttps://ja.player.fm/legal

Hey Medicare Nation!

www.TheMedicareNation.com

Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020!

THREE more plan sponsors to discuss!

CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00!

HUGE Penalty people!

According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Majority of these appeals were from claims from providers (doctors and/or facilities) or ..... reimbursement requests from enrollees.

HCSC has the right to Appeal CMS Decision.

NEXT Up..... is Triple-S Management Corporation!

CMS sent a Notice to Ms. Madeline Hernandez-Urquiza, President of Triple-S Management Corporation, on February 28, 2020.

CMS notified Triple-S that they had made a determination to impose a civil money penalty in the amount of $329,872.00!

CMS reported that Triple-S failed to comply with Medicare requirements related to Part D Formulary and benefit administration.

Triple-S has the right to Appeal CMS decision.

Last up..... is Tufts Health Plan, Inc.

CMS sent notice to Mr. Thomas Crosswell, President and CEO of Tufts Health Plan, Inc., to advise them of CMS' determination to impose a Civil Money Penalty in the amount of $28,302.00.

CMS Auditors reported that Tufts failed to comply with Medicare requirements related to Part D Formulary and benefit administration and coverage determinations, appeals, and grievances in violations of Medicare regulations.

Tufts has the right to Appeal CMS' decision.

If YOU are unhappy with any of the three Medicare Advantage Plan Sponsors, give Medicare a call.

You can request a "Special Election Period," based on your experience with any of these companies.

Call Medicare at 800 - 633 - 4227 24hrs a day, 7 days a week.

www.TheMedicareNation.com

Thank you for listening to Medicare Nation!

If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation!

If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out!

If you have any questions, send them to Support@TheMedicareNation.com

If I can answer it in one email - I will personally answer you!

If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner.

Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show!

Thanks again for listening!

  continue reading

104 つのエピソード

Artwork
iconシェア
 

アーカイブされたシリーズ ("無効なフィード" status)

When? This feed was archived on May 25, 2022 08:29 (2y ago). Last successful fetch was on July 19, 2020 18:35 (3+ y ago)

Why? 無効なフィード status. サーバーは持続期間に有効なポッドキャストのフィードを取得することができませんでした。

What now? You might be able to find a more up-to-date version using the search function. This series will no longer be checked for updates. If you believe this to be in error, please check if the publisher's feed link below is valid and contact support to request the feed be restored or if you have any other concerns about this.

Manage episode 267635136 series 1093150
コンテンツは Diane Daniels によって提供されます。エピソード、グラフィック、ポッドキャストの説明を含むすべてのポッドキャスト コンテンツは、Diane Daniels またはそのポッドキャスト プラットフォーム パートナーによって直接アップロードされ、提供されます。誰かがあなたの著作権で保護された作品をあなたの許可なく使用していると思われる場合は、ここで概説されているプロセスに従うことができますhttps://ja.player.fm/legal

Hey Medicare Nation!

www.TheMedicareNation.com

Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020!

THREE more plan sponsors to discuss!

CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00!

HUGE Penalty people!

According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Majority of these appeals were from claims from providers (doctors and/or facilities) or ..... reimbursement requests from enrollees.

HCSC has the right to Appeal CMS Decision.

NEXT Up..... is Triple-S Management Corporation!

CMS sent a Notice to Ms. Madeline Hernandez-Urquiza, President of Triple-S Management Corporation, on February 28, 2020.

CMS notified Triple-S that they had made a determination to impose a civil money penalty in the amount of $329,872.00!

CMS reported that Triple-S failed to comply with Medicare requirements related to Part D Formulary and benefit administration.

Triple-S has the right to Appeal CMS decision.

Last up..... is Tufts Health Plan, Inc.

CMS sent notice to Mr. Thomas Crosswell, President and CEO of Tufts Health Plan, Inc., to advise them of CMS' determination to impose a Civil Money Penalty in the amount of $28,302.00.

CMS Auditors reported that Tufts failed to comply with Medicare requirements related to Part D Formulary and benefit administration and coverage determinations, appeals, and grievances in violations of Medicare regulations.

Tufts has the right to Appeal CMS' decision.

If YOU are unhappy with any of the three Medicare Advantage Plan Sponsors, give Medicare a call.

You can request a "Special Election Period," based on your experience with any of these companies.

Call Medicare at 800 - 633 - 4227 24hrs a day, 7 days a week.

www.TheMedicareNation.com

Thank you for listening to Medicare Nation!

If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation!

If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out!

If you have any questions, send them to Support@TheMedicareNation.com

If I can answer it in one email - I will personally answer you!

If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner.

Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show!

Thanks again for listening!

  continue reading

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