On March 25, 2015, the sanctions imposed on SummaCare Medicare Advantage plans were lifted by the Centers for Medicare and Medicaid Services (CMS) and SummaCare can once again market and enroll Medicare beneficiaries into their Medicare Advantage plans (H3660).
CMS originally suspended marketing and enrollment activities on August 11, 2014 due to SummaCare's deficiencies in Part C and Part D organization/coverage determinations, appeals and grievances.
In December, 2014, SummaCare attested to CMS that all of the deficiencies cited in the CMS sanction notice were corrected as of December 15, 2014. As a result, CMS authorized a limited enrollment period beginning on January 1, 2015. After review by CMS of the results of an independent audit, CMS has determined that SummaCare’s deficiencies have been sufficiently corrected. Therefore, on March 25, 2015, the intermediate sanctions were released from contract H3660 and the limited enrollment period ended. SummaCare now has normal marketing and enrollment status.
We have updated our Medicare Advantage plan search tool (
MA-Finder) to include the SummaCare Medicare Part D plans along with updated formulary and retail drug cost information.
The complete March 25, 2015 Notice of Release from Intermediate Sanctions from CMS can be found here:
www.cms.gov/ Medicare/ Compliance-and-Audits /Part-C-and-Part-D- Compliance-and-Audits/ Enforcement-Letters-Items/ SummaCareSanction Release032515.html.
You can read more about the August 11, 2014 SummaCare sanction in our Blog:
Q1News.com/372