Florida to shut down Medicare Advantage plan
Florida will liquidate the assets of a Medicare Advantage insurer, ending the company’s short and troubled history.
The state Department of Financial Services took over Florida Healthcare Plus this month, and said the insurer will shut down by Jan. 1. Florida Healthcare Plus has been mired in controversy, including its recent run-in with the FBI.
In November, the FBI went after 11 people associated with Florida Healthcare Plus in an elaborate Medicare fraud scheme that bilked $25.2 million from the federal government. Included was Peter Hernandez, the insurer’s former chief operating officer. The FBI said the defendants submitted phony enrollment applications to receive extra capitated payments from Medicare, claiming some people lived in Florida when they actually lived in Nicaragua and the Dominican Republic. The company was not charged with wrongdoing. Only former employees and those involved in the scheme were charged.
The insurer also attracted the ire of the CMS this past year. The company, which had about 9,000 Medicare Advantage members, had to pay a $113,200 fine in July after the CMS found it inappropriately denied or delayed care to enrollees and violated several rules associated with Medicare’s Part D drug program. The CMS eventually sanctioned the insurer in September, saying it could not enroll any new Medicare members until it rectified its errors.