Check for Sanctions Before Settling on a Medicare Provider During Open or Initial Enrollment

Cigna plans sanctioned, check the Medicare.gov database for sanctioned providers

It’s all well and good to secure your Medicare plan, but one of the many, many things you and your financial planner need to be aware of is the growing list of Medicare plan providers who are under sanctions from the Centers for Medicare and Medicaid Services. This is complicated even further by a recent decision by the CMS to no longer automatically reduce the star ratings for contracts under sanction

In the case of Cigna, which has been under CMS sanctions since January 21, this means hundreds of millions of dollars in bonus payments for some of its Medicare plans—the same plans that led to sanctions in the first place.

The January 2016 sanctions were imposed for “mismanaging those plans in ways that federal officials said threatened seniors’ health and safety,” according to Kaiser Health News.

Cigna’s Medicare plans cover around 493,000 members in 18 states and were sanctioned after a CMS announced that Cigna had received “numerous” notices of noncompliance, warning letters and corrective notices over the last several years. Cigna “had experienced widespread and systemic failures affecting Cigna enrollees’ ability to obtain medical services and prescription medications,” according to CMS and Kaiser Health News.

Other Medicare plan providers that are under sanction can be found via www.CMS.gov, or by contacting i65 and 65 Incorporated.

Though navigating the world of Medicare can be very confusing, i65 and 65 Incorporated are here to help. For more information about sanctioned Medicare plan providers and other topics, head to the 65 Incorporated blog page, where Medicare expert Diane J. Omdahl, RN, MS, shares her wisdom on the twists and turns of the service.