Health Net Sanctioned for Medicare Violations

The Centers for Medicare & Medicaid Services has suspended Woodland Hills-based insurer Health Net from marketing and enrollment activities for its prescription drug and Medicare Advantage plans due to violations of Medicare regulations, the agency announced. The agency also imposed sanctions on Medicare Advantage plans sponsored by Oakland-based Arcadian Management Services and Houston-based Universal American Corporation, which go into effect Dec. 5. The agency identified violations of Medicare rules and regulations by Health Net during an audit of the plan. Immediate sanctions were imposed on the insurer because the company has continued to improperly administer the Medicare drug benefit in its national prescription drug plan and local Medicare Advantage prescription drug plan contracts, the agency said. Centers for Medicare & Medicaid Services will closely monitor the plans until its officials determine that the sponsors have taken corrective actions and that violations are not likely to recur. Failure by the plan sponsors to come into compliance could result in penalties that range from fines to possible contract termination with Medicare. The suspension does not affect current Health Net Medicare enrollees, according to a statement released by Health Net. “We are working closely with CMS to resolve these matters as quickly as possible,” Health Net President and CEO Jay Gellert said in the release. “We hope in the next months we can demonstrate to CMS that we have successfully addressed the issues they have raised.” Jessica Vernabe