UPDATE: On September 2, 2021, CMS published the Notice of Release of Enrollment Suspension for Medicare Advantage - Prescription Drug Plan Contract Number: H1302, stating,
"CMS is releasing the enrollment suspension for contract H1302 effective January 1, 2022. Additionally, CMS will allow Blue Cross of Idaho to offer plans under contract H1302 to new beneficiaries during the CY 2022 Annual Election Period (AEP), which will be held between October 15, 2021 and December 7, 2021."
On September 9, 2020, the Centers for Medicare & Medicaid Services
(CMS) provided notice to Blue Cross of Idaho Care Plus, Inc. (“Blue
Cross of Idaho”) that CMS has made a determination to prohibit the
enrollment of new beneficiaries under the Medicare
Advantage-Prescription Drug (MA-PD) contract H1302
for contract year (CY) 2020.
As a result of this determination, Blue Cross of Idaho will be prohibited from accepting any MA-PD plan enrollments for 2021; this prohibition would be effective for any enrollments beginning January 1, 2021, through December 1, 2021. This action will include the removal of H1302 from the list of MA-PD plans from which beneficiaries may make an election during the CY 2021 Annual Election Period (AEP), which runs between October 15, 2020, and December 7, 2020. However, Blue Cross of Idaho
may continue to accept and process enrollments that become effective on or before December 1, 2020.
Current members of Medicare plans under this contract (H1302) are not
affected by the sanctions and may remain with their 2020 Medicare plan
into 2021. However, during CY 2021, all individual market plans offered under H1302 will be precluded from accepting any new enrollees, including those beneficiaries already enrolled in a Blue Cross of Idaho MA-PD plan who may want to elect a different plan offered under the same contract.
If Blue Cross of Idaho submits a CY 2020 report in 2021 for H1302 that demonstrates it has achieved an MLR of at least 85%, CMS will allow the sponsor to resume accepting enrollments that become effective on or after January 1, 2022. In such an instance, CMS would allow Blue Cross of Idaho to offer plans under H1302 to beneficiaries during the CY 2022 AEP, which will be held between October 15, 2021, and December 7, 2021. In the event that the CY 2020 MLR report for H1302 again shows an MLR below 85%, enrollment under that contract will remain closed during CY 2022. Furthermore, CMS reminds Blue Cross of Idaho that if it fails to report an MLR of at least 85% for five consecutive years for H1302, CMS must terminate that contract.