WellCare To Suspend New Medicare EnrollmentWellCare on Friday said it would suspend new enrollment and marketing for its Medicare plans by March 7, in accordance with a CMS directive, the Wall Street Journal reports. CMS officials cited WellCare's issues with noncompliance, deficiencies in Medicare prescription-drug contracts and misleading of beneficiaries as the reason for the directive. Agency officials said WellCare has the highest number of beneficiary marketing complaints among insurers that offer large Medicare Advantage plans (Wisenberg Brin, Wall Street Journal, 2/21).
In a letter last week, CMS said WellCare "misled and confused Medicare beneficiaries" and "engaged in unauthorized door-to-door solicitation." It also charged that WellCare failed to "discover forged applications through its own monitoring system" and that WellCare agents "misrepresent[ed] WellCare plans at sales events in December 2008." WellCare in a statement said it is "making significant efforts to improve operational effectiveness to address the issues identified by both CMS and the company's own monitoring" (Goldstein, "Health Blog," Wall Street Journal, 2/20). The open enrollment period for 2009 already has passed, allowing WellCare time to address the issues before the 2010 enrollment period begins in November (Wall Street Journal, 2/21). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.