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Tampa Medicare insurer faces federal fines, sanctions

A Tampa Medicare Advantage company faces sanctions and a fine after federal officials found problems with how the company billed customers and handled their prescription drug benefits.

The Centers for Medicare and Medicaid Services issued two notices to Quality Health Plans that it intends to suspend the company from enrolling new members and levy a $586,800 fine, according to a news release.

After receiving complaints from plan members, the agency found that the company had not billed for premiums since January 2008, and recently sent out bills for the entire amount owed, in some cases up to $1,000, according to the agency.

"Many of these enrollees are already financially disadvantaged; the imposition of such a large bill places this vulnerable population in a tough position," Jon Blum, the agency's deputy administrator, said in the release.

The agency also found that the company denied or delayed coverage of approved Part D prescription drugs to members.

Under the sanction, federal officials will monitor the company to ensure corrective actions are taken. If new problems arise, the agency may impose additional penalties or consider terminating the Medicare contract.

The company offers Medicare Advantage and standalone prescription drug plans throughout the Tampa Bay area and a couple of dozen other Florida counties.

It has 17,400 enrollees, nearly all in Florida, though it has begun offering plans in New York.

Most of the plans rated 2.5 stars — between fair and good — on Medicare's five-star quality scale.

"QHP has already started to make changes and implemented outreach programs to ensure that this suspension does not affect any QHP member or provider," Dr. Nazeer Khan, Quality Health Plans' chief executive officer, said in a statement Tuesday.

Richard Martin can be reached at rmartin@sptimes.com or (727) 893-8330.

Tampa Medicare insurer faces federal fines, sanctions 05/18/10 [Last modified: Wednesday, May 19, 2010 12:08am]
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