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Health Net Ordered To Suspend Arizona Medicare Advantage Enrollments

Health NetHealth Net, a provider of Arizona Medicare Advantage plans was ordered by the Centers for Medicare and Medicaid Services (CMS) to cease Medicare enrollment in its programs on November 19. 2010.  The order is part of a sanction imposed by CMS for the improper administration of Medicare Part D plans offered by the health insurance provider.  The sanction affects enrollments in both the company’s Medicare Advantage and Medicare Part D plans, and came just days after the Open Enrollment period began for 2011.

Eligible beneficiaries who are already enrolled in a Health Net Medicare Advantage plan and do not wish to change may remain enrolled in their current plan, but may not elect new plans until the sanctions are lifted.  CMS issued an immediate suspension directed toward Health Net because the agency says that Health Net continued to misadminister its Medicare Part D and Medicare Advantage Part D plans, despite having been warned about its faulty practices during a routine audit of the program.

Health Net has more than 660,000 beneficiaries enrolled in Maricopa and Pima counties. Health Net must now demonstrate that it is in compliance with CMS regulations regarding Medicare Part D benefit administration and that it has taken sufficient steps to ensure that it will remain in compliance.  Once CMS is satisfied with the company’s changes, Health Net will again be allowed to accept new enrollments in its Medicare Advantage and Medicare Part D plans.

“Health Net takes our obligations to our Medicare members seriously,” said Jay Gellert, president and chief executive officer of Health Net, Inc. “Our priority is to help ensure our Medicare members have access to quality health care, customer service and the prescription drugs they need.”

Gellert added, “We are working closely with CMS to resolve these matters as quickly as possible. We hope in the next months we can demonstrate to CMS that we have successfully addressed the issues they have raised. We are committed to the Medicare program and look forward to serving new Medicare beneficiaries once again.”

The sanctions make it unlikely that Health Net will be available as a choice for Arizona Medicare Advantage enrollees during the 2011 Open Enrollment period, which began November 15, 2010 and closes December 31, 2010.

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