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Hey Medicare Nation! www.TheMedicareNation.com Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020! THREE more plan sponsors to discuss! CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00! HUGE Penalty people! According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Ma...

Medicare Nation

CMS Hands Out More Civil Money Penalties to 3 More Medicare Plans

Hey Medicare Nation! Medicare Nation CMS Imposes a Civil Money Penalty against HUMANA! CMS conducted an "Audit" of Humana's Medicare Operations from June 3, 2019 through June 21, 2019. Humana failed to comply with Medicare requirements related to Part D formulary and benefit administration and coverage derterminations, appeals, and grievances in violation of 42 C.F.R. Part 423, Subparts C and M. Humana's failures in these areas were systemic and adversely affected, or had the substantial likelihood of adversely affecting, enrollees. CMS provided notice to Humana's CEO, Mr. Bruce Broussard, on February 28, 2020...

CMS SLAPS Humana With Big Civil Money Penalty

Hey Medicare Nation! Medicare Nation Today, I'm informing you about The Centers For Medicare & Medicaid Services Notice, given to Mr. Art Carlos, CEO of Delaware Life Insurance Company. In a notice dated January 31, 2020, CMS notified Mr. Carlos that they were immediately imposing Intermediate "Sanctions" against Delaware Life Insurance Company. CMS determined that Delaware Life Insurance Company is "in substantial violation of Medicare Advantage and Prescription Drug Plan requirements." SIX specific violations were listed in the notice to Carlos. LISTEN to the episode to learn about the violations a...

CMS Imposes BIG Sanctions on Delaware Life Ins. Company

Hey Medicare Nation! www.TheMedicareNation.com Medicare has taken many steps to assist you during the COVID-19 crisis. Coronavirus tests Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called COVID-19). This test is covered when your doctor or other health care provider orders the test. I spoke about testing for COVID-19 in the previous episode, dated April 1, 2020. Listen to episode 101 to learn more about COVID-19 Testing. Your costs in Original Medicare for COVID-19 Testing. You pay nothing for this test. NAD...

Diane Daniels

Medicare Nation by Diane Daniels

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