CMS fines 17 insurers for Rx plan violations
The CMS slapped nearly half of the health plans offering Medicare prescription drug benefits with fines for improperly denying beneficiaries access to drugs and other services.
The fines were a result of a 2016 audit of 37 health plans made public last week. The agency issued fines to 17 of those plans.
It fined Minnetonka, Minn.-based UnitedHealthcare, the nation’s largest insurer, $2.5 million for failing to comply with a range of Medicare prescription drug requirements. The 17 insurers were fined a total of $7.3 million.
Other fined insurers include WellCare Health Plans of Tampa, Fla., $1.17 million; and Presbyterian Health Plan of Albuquerque, AvMed of Miami, and Community Care HMO of Tulsa, Okla., all of which received penalties of more than $750,000.
Violations of the Medicare Advantage Part D prescription drug requirements led to reduced access to medical services and drugs, the CMS said. Some of the insurers’ plan members were inappropriately denied coverage for drugs, some of which were for acute conditions that needed immediate attention.