CMS lifts Cigna Medicare Part D and Medicare Advantage plan Marketing and Enrollment Sanctions

On Friday, June 16, 2017, the Centers for Medicare and Medicaid Services (CMS) lifted the sanctions imposed on Cigna Medicare Part D and Medicare Advantage plans and Cigna may once again market Medicare plans and enroll Medicare beneficiaries into their Medicare Part D and Medicare Advantage plans.

CMS originally suspended marketing and enrollment activities on January 21, 2016 due to Cigna's deficiencies in:

Part C and Part D organization (Part C)/coverage (Part D) determinations, appeals and grievances,
Part D formulary and benefit administration;
access to facilities and records; and
compliance program effectiveness.

CMS held, "that Cigna’s failures in these [above] areas were widespread and systemic. Violations resulted in [Medicare plan] enrollees experiencing delays or denials in receiving medical services and prescription drugs, and increased out of pocket costs for medical services and prescription drugs."

On March 17, 2017, Cigna attested that all of the deficiencies cited in the CMS sanction notice were corrected. After CMS reviewed the results of an independent audit, CMS determined that Cigna’s deficiencies have been "sufficiently corrected". Accordingly, "effective June 16, 2017, CMS is lifting the intermediate sanctions for Cigna’s contracts and Cigna will return to normal marketing and enrollment status."

We have updated our Medicare Advantage plan search tool (MA-Finder.com) and Medicare Part D plan finder (PDP-Finder.com) to indicate that the Cigna Medicare Advantage plans and Medicare Part D plans are no longer sanctioned. Updated 2017 drug formulary and retail drug cost information will be added as it becomes available. The wholly owned Cigna subsidiaries that were named in the original January 21, 2016 CMS sanctions include: HealthSpring of Alabama, Inc., Cigna Healthcare of Arizona, Inc., HealthSpring of Tennessee, Inc., HealthSpring Life & Health Insurance Company, Inc., Cigna Health and Life Insurance Company, Cigna Healthcare of Georgia, Inc., Bravo Health Mid-Atlantic, Inc., Bravo Health Pennsylvania, Inc., Cigna Healthcare of South Carolina, Inc., Cigna Healthcare of North Carolina, Inc., and HealthSpring of Florida.

The Medicare Part D plans and Medicare Advantage plans impacted by the sanctions included Medicare plan Contract numbers: H0150, H0354, H0439, H1415, H2108, H2165, H3945, H3949, H4407, H4454, H4513, H4528, H5410, H6751, H6972, H7020, H7787, H8423, H9460, H9725, and S5617.

The complete June 16, 2017 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/ Downloads/Cigna_Sanction _Release_06_16_17.pdf.

You can read more about the January 21, 2016 Cigna sanction in our Blog
on this site