Ad-Hoc CAP Summary Report - June 2024 |
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| Contract ID(s) and Names | Parent Organization Name | Organization Contact Name | Organization Contact Phone | Compliance Issue ID | Date Letter Sent | Issue Type | Issue Topic | Issue Summary | Letter Name |
|---|---|---|---|---|---|---|---|---|---|
|
H3925 - PENNSYLVANIA PACE, INC. |
Pennsylvania PACE, Inc. | Mark Irwin | 8145356000 | 82052 | 29-MAY-2024 | Health and Drug Benefit | PACE-specific Issues | Failure to Properly Administer and Document Medications Across All Care Settings. | 82052_0_05292024144226497_H0819_H2992_H3925_H5902_Senior LIFE - CAP.pdf |
|
H5902 - SENIOR LIFE ALTOONA, INC. |
Senior LIFE Altoona, Inc. | Mark Irwin | 8145356000 | 82053 | 29-MAY-2024 | Health and Drug Benefit | PACE-specific Issues | Failure to Properly Administer and Document Medications Across All Care Settings. | 82053_0_05292024144319377_H0819_H2992_H3925_H5902_Senior LIFE - CAP.pdf |
|
H0819 - SENIOR LIFE YORK, INC. |
Senior LIFE York, Inc. | Mark Irwin | 8145356000 | 82050 | 29-MAY-2024 | Health and Drug Benefit | PACE-specific Issues | Failure to Properly Administer and Document Medications Across All Care Settings. | 82050_0_05292024143920659_H0819_H2992_H3925_H5902_Senior LIFE - CAP.pdf |
|
H2992 - SENIORLIFE WASHINGTON, INC. |
SeniorLife Washington, Inc. | Mark Irwin | 8145356000 | 82051 | 29-MAY-2024 | Health and Drug Benefit | PACE-specific Issues | Failure to Properly Administer and Document Medications Across All Care Settings. | 82051_0_05292024144041793_H0819_H2992_H3925_H5902_Senior LIFE - CAP.pdf |
|
H2064 - GEISINGER COMMUNITY HEALTH SERVICES |
Risant Health, Inc. | Teena Kubasti | 5702149790 | 80977 | 05-MAR-2024 | Health and Drug Benefit | PACE-specific Issues | Failure to Provide Medically Necessary Covered Services | 80977_0_03052024111352792_H2064 LIFE Geisinger - CAP.pdf |
|
H8492 - DIGNITY CARE CORPORATION |
Mitchell Family Office | Angie Brimm | 8662666010 | 80940 | 26-FEB-2024 | Health and Drug Benefit | Agent/Broker Compensation | Failure to timely submit agent/broker compensation data | 80940_0_02272024124501736_Dignity Care Corp_H8492 CAP ABC Failure to timely submit.pdf |
|
H5945 - PROMINENCE HEALTHFIRST |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 80572 | 01-FEB-2024 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to be Properly Licensed | 80572_0_02012024075751290_H5945 CAP_2.1.24.pdf |
|
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. |
Commonwealth Care Alliance, Inc. | Member Services | 8663333530 | 80431 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 80434 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H4286 - LEON HEALTH, INC. |
LMC Family Holdings, LLC | Marcus Gomez | 3056442156 | 80430 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H3811 - SAMARITAN HEALTH PLANS, INC. |
Samaritan Health Services | Janice Crayk | 5417685192 | 80432 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H5410 - HEALTHSPRING OF FLORIDA, INC. |
The Cigna Group | Jared Rich | 8006683813 | 80433 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H4961 - ALIGNMENT HEALTH PLAN |
Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 79995 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S6506 - BLUE CROSS AND BLUE SHIELD ARIZONA, INC. |
Blue Cross Blue Shield of Arizona | 80193 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9147 - BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH |
Blue Cross and Blue Shield of North Carolina | Member Services | 8882969790 | 80022 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9147 - BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH |
Blue Cross and Blue Shield of North Carolina | Member Services | 8882969790 | 80176 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3015 - SHARED HEALTH MISSISSIPPI, INC. |
BlueCross BlueShield of Tennessee | Customer Service | 8772583002 | 80132 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0838 - UNIVERSAL CARE, INC. |
Bright Health Group, Inc. | 80120 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S8067 - Avalon Insurance Company |
CAPITAL BLUE CROSS | Gloria Yu | 8666882242 | 80196 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0523 - AETNA HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 79972 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4982 - AETNA BETTER HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 79996 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6399 - AETNA BETTER HEALTH INC. (NJ) |
CVS Health Corporation | Matt Koblens | 8443620934 | 80005 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4711 - COVENTRY HEALTH CARE OF NEBRASKA, INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 80147 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | 80003 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | 80151 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0074 - WELLCARE OF MISSISSIPPI, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79967 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | 79968 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0111 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79969 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0270 - WELLCARE HEALTH INSURANCE COMPANY OF AMERICA |
Centene Corporation | Website Inquiries | 8888889355 | 79970 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0482 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | 79971 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Member Services | 8663897690 | 79974 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE |
Centene Corporation | 79975 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1215 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Health Net | 8008676564 | 79977 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | 79979 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1395 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8667960530 | 79980 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Health Net | 8008676564 | 79981 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 79984 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2117 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79985 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2128 - CELTIC INSURANCE COMPANY |
Centene Corporation | Member Services | 8557661452 | 79986 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2853 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8555659519 | 79989 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3047 - WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA |
Centene Corporation | Website Inquiries | 8888889355 | 79990 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Provider Services | 8662968731 | 79991 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4506 - SELECTCARE OF TEXAS, INC. |
Centene Corporation | Provider Services | 8662968731 | 79992 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | 79994 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5439 - HEALTH NET LIFE INSURANCE COMPANY |
Centene Corporation | Provider Services | 8002754737 | 79997 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 79998 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Centene Corporation | Provider Services | 8662968731 | 79999 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6348 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 80004 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 80006 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6605 - WELLCARE HEALTH INSURANCE OF HAWAII, INC. |
Centene Corporation | 80007 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6678 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | 80008 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6713 - WELLCARE OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80009 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 80010 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7169 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 80011 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7323 - WELLCARE NATIONAL HEALTH INSURANCE COMPANY |
Centene Corporation | Website Inquiries | 8888889355 | 80012 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7399 - CENTENE VENTURE COMPANY ILLINOIS |
Centene Corporation | 80013 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7512 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | Provider Services | 8662968731 | 80014 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7518 - WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 80015 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8225 - CENTENE VENTURE COMPANY FLORIDA |
Centene Corporation | 80018 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80020 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8711 - WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY |
Centene Corporation | Website Inquiries | 8888889355 | 80021 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9335 - WELLCARE HEALTH PLANS OF MISSOURI, INC. |
Centene Corporation | 80024 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9357 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | 80025 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8555659519 | 80026 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | 80027 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9761 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | 80028 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9811 - MAGNOLIA HEALTH PLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 80029 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9900 - WELLCARE OF OKLAHOMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80030 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9976 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 80031 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0074 - WELLCARE OF MISSISSIPPI, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80116 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | 80117 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Member Services | 8663897690 | 80119 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80121 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1215 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Health Net | 8008676564 | 80122 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | 80123 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 80126 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2117 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80127 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2128 - CELTIC INSURANCE COMPANY |
Centene Corporation | Member Services | 8557661452 | 80128 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3499 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 80136 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 80138 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Provider Services | 8662968731 | 80139 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4343 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. |
Centene Corporation | 80142 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | 80146 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON |
Centene Corporation | Provider Services | 8662968731 | 80150 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6193 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | 80152 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6348 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 80153 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6605 - WELLCARE HEALTH INSURANCE OF HAWAII, INC. |
Centene Corporation | 80156 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 80158 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7169 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 80161 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7512 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | Provider Services | 8662968731 | 80163 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8225 - CENTENE VENTURE COMPANY FLORIDA |
Centene Corporation | 80171 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8555659519 | 80177 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | 80179 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9761 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | 80181 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9811 - MAGNOLIA HEALTH PLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 80182 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9900 - WELLCARE OF OKLAHOMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80185 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9976 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 80187 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8010 - CLOVER HMO OF NEW JERSEY INC. |
Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 80168 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8492 - DIGNITY CARE CORPORATION |
CommCare Corporation | Angie Brimm | 8662666010 | 80173 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9414 - Commonwealth Care Alliance Massachusetts, LLC. |
Commonwealth Care Alliance, Inc. | Member Services | 8664209332 | 80178 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9861 - CCA HEALTH MICHIGAN, INC. |
Commonwealth Care Alliance, Inc. | Member Services | 8559595855 | 80184 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0544 - BLUE CROSS OF CALIFORNIA |
Elevance Health, Inc. | Customer Service | 8882307338 | 79973 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1732 - ANTHEM HP, LLC |
Elevance Health, Inc. | 79982 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2593 - WELLPOINT TEXAS, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 79988 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 80019 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1732 - ANTHEM HP, LLC |
Elevance Health, Inc. | 80125 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7093 - COMMUNITY INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 80159 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 80175 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3467 - PROCARE ADVANTAGE, LLC |
First Sacramento Capital Funding LLC | Sukumaran Karunakaran | 8043966384 | 80135 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 80133 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6379 - CLEAR SPRING HEALTH (CO), INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 80155 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8293 - CLEAR SPRING HEALTH (VA), INC. |
Group 1001 | 80172 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0034 - HAMASPIK, INC. |
Hamaspik of Rockland County, Inc. | Karl Dehm | 8455030569 | 80115 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9826 - COMMUNITY HEALTH CHOICE TEXAS, INC. |
Harris County Hospital District | Tawnya Schoech | 7133145667 | 80183 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1666 - HCSC INSURANCE SERVICES COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 80124 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4801 - GHS INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 80148 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8547 - ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 80174 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9706 - HCSC INSURANCE SERVICES COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 80180 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5993 - HORIZON INSURANCE COMPANY |
Horizon Mutual Holdings, Inc | Suze Mestres | 9734665503 | 80192 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
R4845 - HUMANA INSURANCE COMPANY |
Humana Inc. | 80188 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | 80190 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1225 - HOPKINS HEALTH ADVANTAGE, INC. |
Johns Hopkins Healthcare LLC | Salma Riaz | 4107625905 | 79978 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6351 - LIBERTY ADVANTAGE, LLC |
Liberty Healthcare Insurance | David ORourke | 8448546884 | 80154 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9306 - ALTERWOOD ADVANTAGE, INC. |
LifeBridge Health, Inc. | David Margolit | 6672629412 | 80023 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7557 - LONGEVITY HEALTH PLAN OF MICHIGAN, INC. |
Longevity Health Founders, LLC | Beth Socoski | 8883133609 | 80164 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2722 - Primewell Health Services of Arkansas, Inc. |
Louisiana Health Service & Indemnity Company | Amy Trichel | 8888231910 | 80129 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7163 - Primewell Health Services of Mississippi Inc. |
Louisiana Health Service & Indemnity Company | Amy Trichel | 8888231910 | 80160 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4232 - AMERICAN HEALTH PLAN OF UT, INC. |
Mitchell Family Office | Angie Brimm | 8555210627 | 80141 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4490 - AMERICAN HEALTH PLAN OF MISSOURI, INC. |
Mitchell Family Office | Angie Brimm | 8442287934 | 80143 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6891 - AMERICAN HEALTH PLAN OF TX, INC. |
Mitchell Family Office | Angie Brimm | 8555210628 | 80157 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3813 - MODA HEALTH PLAN, INC. |
Moda Partners, Inc. | Customer Service | 8772999062 | 80137 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5810 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80000 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006651029 | 80001 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80002 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80016 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80017 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. |
Molina Healthcare, Inc. | 80131 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80149 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80165 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80166 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8176 - MOLINA HEALTHCARE OF SOUTH CAROLINA,INC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80170 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9955 - MOLINA HEALTHCARE OF OHIO, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 80186 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S7126 - OMAHA HEALTH INSURANCE COMPANY |
Mutual of Omaha Insurance Company | 80194 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | 80134 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8067 - PROVIDER PARTNERS HEALTH PLAN, INC. |
Rifkin Managed Care Holding, LLC | Sue Radice | 4109913213 | 80169 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 80195 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2400 - SIGNATURE ADVANTAGE, LLC |
SA Plan, LLC | Shawna Hearing | 8442148633 | 79987 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0978 - SCAN HEALTH PLAN NEVADA, INC. |
SCAN Group | Kim McBeath | 8777787226 | 79976 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1822 - SCAN DESERT HEALTH PLAN, INC. |
SCAN Group | Kim McBeath | 8777787226 | 79983 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S2668 - MEMBERS HEALTH INSURANCE COMPANY |
Tennessee Rural Health Improvement Association | Tracy Ring | 8339990135 | 80189 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0672 - CIGNA HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Jared Rich | 8006683813 | 80118 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7389 - CIGNA HEALTH AND LIFE INSURANCE COMPANY |
The Cigna Group | Jared Rich | 8006683813 | 80162 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Jared Rich | 8006683813 | 80167 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
The Cigna Group | Russ Meadows | 8002226700 | 80191 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4676 - TROY HEALTH, INC. |
Troy Holdings, Inc. | Flaviu Simihaian | 7042758900 | 79993 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4676 - TROY HEALTH, INC. |
Troy Holdings, Inc. | Flaviu Simihaian | 7042758900 | 80145 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
R3175 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | UHC Customer Service | 8666228054 | 80032 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4094 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | 80140 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4544 - PEOPLES HEALTH, INC. |
UnitedHealth Group, Inc. | Thomas Gennaro | 5046818537 | 80144 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | 80130 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2694 - ETERNALHEALTH, INC. |
Eternal Health of Delaware, Inc. | Provider Services | 8006809255 | 79523 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 79528 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H2960 - HOMETOWN HEALTH PLAN, INC. |
Renown Health | CJ Bawden | 7759823218 | 79526 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H9042 - SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC. |
SIHO Holding, Inc. | Michelle Jones | 8123787107 | 79527 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H4863 - TRH HEALTH INSURANCE COMPANY |
Tennessee Rural Health Improvement Association | Tracy Ring | 8339990135 | 79525 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H2459 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 79524 | 27-NOV-2023 | Health Benefit | Provider Directory | Inaccurate Provider Directory | Ad-Hoc CAP-letter.pdf |
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 79302 | 25-OCT-2023 | Health and Drug Benefit | Accuracy & Accessibility Study | ACC CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
S6946 - CLEAR SPRING HEALTH INSURANCE COMPANY |
Group 1001 | Elizabeth Cuevas | 7542085880 | 79127 | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
H8961 - OSCAR MANAGED CARE OF SOUTH FLORIDA, INC |
Oscar Health, Inc. | 79298 * | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2023 | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 79124 | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2023 | Ad-Hoc CAP-letter.pdf | ||
|
H4676 - TROY HEALTH, INC. |
Troy Holdings, Inc. | Flaviu Simihaian | 7042758900 | 79303 | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | ACC CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
H9455 - HEALTH CHOICE UTAH, INC. |
University of Utah | 79126 * | 25-OCT-2023 | Health Benefit | Accuracy & Accessibility Study | LEP CAP 2023 | Ad-Hoc CAP-letter.pdf | ||
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | 79297 | 25-OCT-2023 | Health and Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2023 | Ad-Hoc CAP-letter.pdf | ||
|
H4227 - VISTA HEALTH PLAN, INC. |
Independence Health Group, Inc. | Provider Services | 8005216007 | 78387 | 10-OCT-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY 2019 MLR and CY 2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H4853 - BRIGHT HEALTH COMPANY OF ARIZONA |
Bright Health Group, Inc. | 77830 * | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf | ||
|
H6988 - CENTERS PLAN FOR HEALTHY LIVING, LLC |
Centers Plan for Healthy Living, LLC | Natalie Fernandes | 7182157000 | 77828 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H9861 - CCA HEALTH MICHIGAN, INC. |
Commonwealth Care Alliance, Inc. | Member Services | 8559595855 | 77831 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H3777 - EXPERIENCE HEALTH, INC. |
EXPERIENCE HEALTH, INC. | Member Services | 8882969790 | 77824 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H9306 - ALTERWOOD ADVANTAGE, INC. |
LifeBridge Health, Inc. | David Margolit | 6672629412 | 77826 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H2678 - MoreCare, Inc. |
MHNU Corporation | 77825 * | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf | ||
|
H3186 - SANFORD HEALTH PLAN OF MINNESOTA |
Sanford Health | Aleesa Jansick | 6053287182 | 77829 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H7646 - PHP MEDICARE |
University of Michigan Health | PHP CustomerService | 8445293757 | 77827 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H0628 - AETNA HEALTH OF OHIO INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 76930 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H1610 - COVENTRY HEALTH CARE OF VIRGINIA, INC. |
CVS Health Corporation | Matt Koblens | 8554630933 | 76931 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H3192 - AETNA HEALTH OF MICHIGAN INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 76933 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H4835 - AETNA BETTER HEALTH OF OKLAHOMA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 76934 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H5325 - COVENTRY HEALTH CARE OF KANSAS, INC. |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 76935 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H7149 - AETNA HEALTH INC. (PA) |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 76936 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H7301 - COVENTRY HEALTH CARE OF ILLINOIS, INC. |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 76937 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H8649 - AETNA HEALTH OF UTAH INC. |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 76938 | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H2829 - INNOVATION HEALTH PLAN, INC. |
Innovation Health Holdings, LLC | 76932 * | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf | ||
|
H4739 - SELECT HEALTH OF SOUTH CAROLINA, INC. |
Independence Health Group, Inc. | Provider Services | 8889780862 | 75790 | 30-MAR-2023 | Health Benefit | Timeliness Study | CCM SI CAP TIMELINESS (Q4 2022) | Ad-Hoc CAP-letter.pdf |
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | 75791 | 30-MAR-2023 | Health and Drug Benefit | Timeliness Study | CCM SI CAP TIMELINESS (Q4 2022) | Ad-Hoc CAP-letter.pdf | ||
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 75208 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S6506 - BLUE CROSS AND BLUE SHIELD ARIZONA, INC. |
Blue Cross Blue Shield of Arizona | 75237 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S5953 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA |
BlueCross BlueShield of South Carolina (BCBSSC) | Provider Services | 8003342583 | 75236 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4982 - AETNA BETTER HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 75197 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5302 - AETNA HEALTH INC. (GA) |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 75201 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6399 - AETNA BETTER HEALTH INC. (NJ) |
CVS Health Corporation | Matt Koblens | 8443620934 | 75210 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | 75209 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
CareFirst, Inc. | Member Services | 8443866762 | 75226 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3499 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 75191 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 75192 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4343 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. |
Centene Corporation | 75193 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4847 - WELLCARE OF SOUTH CAROLINA, INC. |
Centene Corporation | Provider Services | 8662968731 | 75195 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5087 - WELLCARE OF CALIFORNIA, INC. |
Centene Corporation | Provider Services | 8662968731 | 75198 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5117 - LOUISIANA HEALTHCARE CONNECTIONS, INC. |
Centene Corporation | Provider Services | 8557661572 | 75199 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | 75200 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5398 - CENTENE VENTURE COMPANY KANSAS |
Centene Corporation | Provider Services | 8555659519 | 75202 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5430 - ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC. |
Centene Corporation | 75203 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 75204 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Centene Corporation | Provider Services | 8662968731 | 75207 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 75211 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6713 - WELLCARE OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75213 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 75214 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75216 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7323 - WELLCARE NATIONAL HEALTH INSURANCE COMPANY |
Centene Corporation | Website Inquiries | 8888889355 | 75217 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7326 - WELLCARE OF SOUTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75218 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7518 - WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 75220 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75224 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8711 - WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY |
Centene Corporation | Website Inquiries | 8888889355 | 75225 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9335 - WELLCARE HEALTH PLANS OF MISSOURI, INC. |
Centene Corporation | 75230 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | 75231 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9861 - CCA HEALTH MICHIGAN, INC. |
Commonwealth Care Alliance, Inc. | Member Services | 8559595855 | 75232 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4346 - HMO COLORADO, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 75194 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4909 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 75196 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
Elevance Health, Inc. | 75206 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8343 - AMERIGROUP INSURANCE COMPANY |
Elevance Health, Inc. | 75222 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 75223 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S3375 - EMPIRE HEALTHCHOICE ASSURANCE, INC. |
Elevance Health, Inc. | 75234 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S8182 - AMERIGROUP INSURANCE COMPANY |
Elevance Health, Inc. | 75241 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S6946 - CLEAR SPRING HEALTH INSURANCE COMPANY |
Group 1001 | Elizabeth Cuevas | 7542085880 | 75238 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5904 - BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. |
Guidewell Mutual Holding Corporation | Medicare Mbr Svcs | 8009266565 | 75235 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 75227 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | 75233 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5496 - IMPERIAL HEALTH PLAN OF CALIFORNIA, INC. |
Imperial Health Plan of California | Erica Ruiz | 8007087903 | 75205 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7163 - Primewell Health Services of Mississippi Inc. |
Louisiana Health Service & Indemnity Company | Amy Trichel | 8888231910 | 75215 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. |
Molina Healthcare, Inc. | 75221 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 75229 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S7126 - OMAHA HEALTH INSURANCE COMPANY |
Mutual of Omaha Insurance Company | 75239 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8961 - OSCAR MANAGED CARE OF SOUTH FLORIDA, INC |
Oscar Health, Inc. | 75228 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 75240 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6526 - UNITEDHEALTHCARE OF NEW MEXICO, INC. |
UnitedHealth Group, Inc. | 75212 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | 75219 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0838 - UNIVERSAL CARE, INC. |
Bright Health Group, Inc. | 75170 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H3281 - BRIGHT HEALTH INSURANCE COMPANY OF FLORIDA |
Bright Health Group, Inc. | 75190 * | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2056 - AETNA BETTER HEALTH OF MICHIGAN INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 75181 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0111 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75119 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0351 - HEALTH NET OF ARIZONA, INC. |
Centene Corporation | Provider Services | 8009777522 | 75120 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE |
Centene Corporation | 75122 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1112 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75123 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | 75124 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1416 - HARMONY HEALTH PLAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75126 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Health Net | 8008676564 | 75127 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75130 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2134 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 75132 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2775 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY |
Centene Corporation | Website Inquiries | 8888889355 | 75133 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2915 - PENNSYLVANIA HEALTH & WELLNESS, INC. |
Centene Corporation | Member Services | 8557661452 | 75134 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3047 - WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA |
Centene Corporation | Website Inquiries | 8888889355 | 75135 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 75138 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5117 - LOUISIANA HEALTHCARE CONNECTIONS, INC. |
Centene Corporation | Provider Services | 8557661572 | 75142 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5190 - SUNSHINE STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8667960530 | 75143 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | 75144 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 75146 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 75150 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6594 - WELLCARE HEALTH PLANS OF VERMONT, INC. |
Centene Corporation | 75152 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6713 - WELLCARE OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75153 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75154 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7323 - WELLCARE NATIONAL HEALTH INSURANCE COMPANY |
Centene Corporation | Website Inquiries | 8888889355 | 75155 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8711 - WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY |
Centene Corporation | Website Inquiries | 8888889355 | 75157 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0074 - WELLCARE OF MISSISSIPPI, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75159 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | 75160 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0111 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75161 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0174 - WELLCARE OF TEXAS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75162 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0270 - WELLCARE HEALTH INSURANCE COMPANY OF AMERICA |
Centene Corporation | Website Inquiries | 8888889355 | 75163 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0482 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | 75165 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0562 - HEALTH NET OF CALIFORNIA, INC. |
Centene Corporation | Provider Services | 8002754737 | 75166 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0712 - WELLCARE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75168 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Member Services | 8663897690 | 75169 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE |
Centene Corporation | 75171 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | 75172 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1416 - HARMONY HEALTH PLAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75174 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Health Net | 8008676564 | 75176 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 75178 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 75180 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2134 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 75183 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2775 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY |
Centene Corporation | Website Inquiries | 8888889355 | 75184 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2853 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8555659519 | 75185 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3047 - WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA |
Centene Corporation | Website Inquiries | 8888889355 | 75187 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. |
Commonwealth Care Alliance, Inc. | Member Services | 8663333530 | 75175 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON |
Community Health Plan of Washington | Customer Care | 8009420247 | 75149 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1732 - ANTHEM HP, LLC |
Elevance Health, Inc. | 75128 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 75129 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4346 - HMO COLORADO, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 75139 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
Elevance Health, Inc. | 75148 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1732 - ANTHEM HP, LLC |
Elevance Health, Inc. | 75177 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 75179 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3276 - CONNECTICARE INSURANCE COMPANY, INC. |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 75137 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3276 - CONNECTICARE INSURANCE COMPANY, INC. |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 75189 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 75188 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5496 - IMPERIAL HEALTH PLAN OF CALIFORNIA, INC. |
Imperial Health Plan of California | Erica Ruiz | 8007087903 | 75147 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 75158 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. |
Molina Healthcare, Inc. | 75186 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4675 - HEALTHIER NEW JERSEY INSURANCE COMPANY |
NJ Collaborative Care, LLC | 75140 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5433 - ORANGE COUNTY HEALTH AUTHORITY |
Orange County Health Authority | Customer Service | 8774122734 | 75145 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | 75136 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 75394 | 22-FEB-2023 | Drug Benefit | OMS | Failure to comply with the Part D DMP access limitation requirements | Ad-Hoc CAP-letter.pdf | ||
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H0672 - CIGNA HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Jared Rich | 8006683813 | 75121 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. |
The Cigna Group | Jared Rich | 8006683813 | 75164 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H0672 - CIGNA HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Jared Rich | 8006683813 | 75167 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H2108 - BRAVO HEALTH MID-ATLANTIC, INC. |
The Cigna Group | Jared Rich | 8006683813 | 75182 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1375 - UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC |
UnitedHealth Group, Inc. | 75125 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4829 - UHC OF CALIFORNIA |
UnitedHealth Group, Inc. | 75141 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H6526 - UNITEDHEALTHCARE OF NEW MEXICO, INC. |
UnitedHealth Group, Inc. | 75151 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H7445 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | 75156 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H1375 - UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC |
UnitedHealth Group, Inc. | 75173 * | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H1924 - LASSO HEALTHCARE INSURANCE COMPANY |
Zing Health Consolidator, Inc | 75131 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2593 - WELLPOINT TEXAS, INC. H3240 - WELLPOINT NEW JERSEY, INC. H3447 - HEALTHKEEPERS, INC. H3655 - COMMUNITY INSURANCE COMPANY H4346 - HMO COLORADO, INC. H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA H5817 - AMERIGROUP TEXAS, INC. H7200 - AMERIGROUP TENNESSEE, INC. H8432 - ANTHEM HEALTHCHOICE HMO, INC. H9525 - COMPCARE HEALTH SERVICES INSURANCE CORPORATION H9886 - HMO MISSOURI, INC. R5941 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 74889 | 13-FEB-2023 | Health Benefit | Appeals and Grievances, Including Coverage/Organization Determination | This determination relates to Elevance's failure to follow the CMS Medicare Advantage ("MA") administrative appeals process which grants non-contracted providers the right to appeal adverse payment determinations which are reopened and revised on post-payment review. | 74889_02132023104339534_1.Corrective Action Plan for Elevance Failure to Forward Cases to IRE__2.13.2023.pdf |
|
H3815 - ALIGNMENT HEALTH PLAN |
Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 74085 | 28-JAN-2023 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2023 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H5959 - BCBSM, Inc. |
Aware Integrated, Inc. | Patrick Cosgrove | 6516623727 | 74086 | 28-JAN-2023 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2023 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H3330 - HEALTH INSURANCE PLAN OF GREATER NEW YORK |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 74087 | 28-JAN-2023 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2023 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H1035 - FLORIDA BLUE MEDICARE, INC. |
Guidewell Mutual Holding Corporation | Medicare Mbr Svcs | 8009266565 | 74088 | 28-JAN-2023 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2023 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H8070 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 74089 | 28-JAN-2023 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2023 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H5211 - SECURITY HEALTH PLAN OF WISCONSIN, INC. |
Marshfield Clinic Health System, Inc. | Ken Baur | 7152219556 | 73871 | 11-JAN-2023 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY 2023 Formulary Requirements | Ad-Hoc CAP-letter.pdf |
|
H2537 - ALBRIGHT CARE SERVICES |
SpiritTrust Lutheran | 73227 | 01-DEC-2022 | Health Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to Maintain Fiscal Soundness | 73227_12012022083010361_1.H2537 - SpiriTrust Lutheran LIFE_ CAP Continuation_12-01-2022.pdf | ||
|
H2506 - AETNA BETTER HEALTH PREMIER PLAN MMAI INC. |
CVS Health Corporation | Matt Koblens | 8666002139 | 72769 | 26-OCT-2022 | Health and Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
H8026 - AETNA BETTER HEALTH OF MICHIGAN INC. |
CVS Health Corporation | Matt Koblens | 8556765771 | 72771 | 26-OCT-2022 | Health and Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
H0022 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 72765 | 26-OCT-2022 | Health and Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
H1723 - ABSOLUTE TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8664336041 | 72768 | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
H8786 - WEllPOINT TEXAS, INC. |
Elevance Health, Inc. | 72766 | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2022 | Ad-Hoc CAP-letter.pdf | ||
|
H4922 - AGEWELL NEW YORK, LLC |
ParkerCare New York, LLC | 72770 * | 26-OCT-2022 | Health Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 72767 | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2022 | Ad-Hoc CAP-letter.pdf | ||
|
H9877 - VIRGINIA PREMIER HEALTH PLAN, INC. |
Sentara Health Care (SHC) | 70347 * | 30-JUN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2019 and CY 2020 reporting year. | Ad-Hoc CAP-letter.pdf | ||
|
H9955 - MOLINA HEALTHCARE OF OHIO, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68445 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 68444 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8845 - MOLINA HEALTHCARE OF ARIZONA, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68443 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8677 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | 68442 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8423 - Molina Healthcare of Texas, Inc. |
Molina Healthcare, Inc. | 68441 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8197 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8668568699 | 68440 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8176 - MOLINA HEALTHCARE OF SOUTH CAROLINA,INC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68439 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. |
Molina Healthcare, Inc. | 68438 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8046 - MOLINA HEALTHCARE OF ILLINOIS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68437 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7844 - MOLINA HEALTHCARE OF MICHIGAN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68436 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68435 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68434 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5992 - SENIOR WHOLE HEALTH OF NEW YORK, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68433 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68432 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006651029 | 68431 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5810 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68430 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5628 - MOLINA HEALTHCARE OF UTAH, INC. |
Molina Healthcare, Inc. | Member Services | 8886651328 | 68429 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5280 - MOLINA HEALTHCARE OF OHIO, INC. |
Molina Healthcare, Inc. | Member Services | 8556654623 | 68428 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. |
Molina Healthcare, Inc. | 68427 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H2533 - MOLINA HEALTHCARE OF SOUTH CAROLINA, INC. |
Molina Healthcare, Inc. | Member Services | 8557355831 | 68426 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2224 - SENIOR WHOLE HEALTH, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68425 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1799 - MOLINA HEALTHCARE OF KENTUCKY, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 68424 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
S4802 - WELLCARE PRESCRIPTION INSURANCE, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68554 | 26-MAY-2022 | Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9976 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 68553 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H9900 - WELLCARE OF OKLAHOMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68552 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9811 - MAGNOLIA HEALTH PLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 68551 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9761 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | 68550 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 68549 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9630 - ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8555659518 | 68548 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | 68547 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8555659519 | 68546 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9364 - WELLCARE OF MAINE, INC. |
Centene Corporation | Provider Services | 8555659519 | 68545 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9357 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | 68544 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H9335 - WELLCARE HEALTH PLANS OF MISSOURI, INC. |
Centene Corporation | 68543 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H9276 - SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8667960530 | 68542 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H9258 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | 68541 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8711 - WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY |
Centene Corporation | Website Inquiries | 8888889355 | 68540 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68539 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8458 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 68538 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8225 - CENTENE VENTURE COMPANY FLORIDA |
Centene Corporation | 68537 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. |
Centene Corporation | Provider Services | 8002229831 | 68536 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H8121 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8667960530 | 68535 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7925 - CENTENE VENTURE COMPANY INDIANA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68534 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7556 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. |
Centene Corporation | 68533 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H7518 - WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 68532 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7512 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | Provider Services | 8662968731 | 68531 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7399 - CENTENE VENTURE COMPANY ILLINOIS |
Centene Corporation | 68530 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H7360 - HEALTH NET OF CALIFORNIA, INC. |
Centene Corporation | 68529 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H7326 - WELLCARE OF SOUTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68528 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7323 - WELLCARE NATIONAL HEALTH INSURANCE COMPANY |
Centene Corporation | Website Inquiries | 8888889355 | 68527 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68526 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H7173 - PEACH STATE HEALTH PLAN, INC. |
Centene Corporation | 68525 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H7169 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 68524 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 68523 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6870 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Provider Services | 8773915921 | 68522 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6830 - CENTENE VENTURE COMPANY KANSAS |
Centene Corporation | Provider Services | 8555659519 | 68521 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6815 - HEALTH NET HEALTH PLAN OF OREGON, INC. |
Centene Corporation | Provider Services | 8884458913 | 68520 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6713 - WELLCARE OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68519 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6678 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | 68518 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6605 - WELLCARE HEALTH INSURANCE OF HAWAII, INC. |
Centene Corporation | 68517 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6594 - WELLCARE HEALTH PLANS OF VERMONT, INC. |
Centene Corporation | 68516 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6550 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8555659519 | 68515 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 68514 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6348 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 68513 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H6193 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | 68512 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H6080 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Centene Corporation | Member Services | 8553234578 | 68511 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON |
Centene Corporation | Provider Services | 8662968731 | 68510 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Centene Corporation | Provider Services | 8662968731 | 68509 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5599 - NEW YORK QUALITY HEALTHCARE CORPORATION |
Centene Corporation | Fidelis Member Services | 8002471447 | 68508 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5590 - Bridgeway Health Solutions of Arizona, Inc. |
Centene Corporation | Provider Services | 8773915921 | 68507 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 68506 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5439 - HEALTH NET LIFE INSURANCE COMPANY |
Centene Corporation | Provider Services | 8002754737 | 68505 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5430 - ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC. |
Centene Corporation | 68504 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H5398 - CENTENE VENTURE COMPANY KANSAS |
Centene Corporation | Provider Services | 8555659519 | 68503 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5294 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 68502 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | 68501 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H5190 - SUNSHINE STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8667960530 | 68500 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5117 - LOUISIANA HEALTHCARE CONNECTIONS, INC. |
Centene Corporation | Provider Services | 8557661572 | 68499 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H5087 - WELLCARE OF CALIFORNIA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68498 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H4868 - NEW YORK QUALITY HEALTHCARE CORPORATION |
Centene Corporation | Provider Services | 8662968731 | 68497 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H4847 - WELLCARE OF SOUTH CAROLINA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68496 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | 68495 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H4537 - WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68494 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H4506 - SELECTCARE OF TEXAS, INC. |
Centene Corporation | Provider Services | 8662968731 | 68493 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H4343 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. |
Centene Corporation | 68492 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68491 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 68490 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H3561 - HEALTH NET COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8002754737 | 68489 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H3499 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8557661541 | 68488 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H3237 - HEALTH NET COMMUNITY SOLUTIONS, INC. |
Centene Corporation | 68487 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H3047 - WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA |
Centene Corporation | Website Inquiries | 8888889355 | 68486 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2915 - PENNSYLVANIA HEALTH & WELLNESS, INC. |
Centene Corporation | Member Services | 8557661452 | 68485 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2853 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8555659519 | 68484 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2816 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY |
Centene Corporation | Website Inquiries | 8888889355 | 68483 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2775 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY |
Centene Corporation | Website Inquiries | 8888889355 | 68482 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68481 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2174 - TRILLIUM COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8448671156 | 68480 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2162 - WELLCARE OF NEW HAMPSHIRE, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68479 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2134 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | 68478 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H2128 - CELTIC INSURANCE COMPANY |
Centene Corporation | Member Services | 8557661452 | 68477 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2117 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68476 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68475 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
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H1862 - WELLCARE HEALTH PLANS OF VERMONT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68474 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | 68473 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H1774 - CENTENE VENTURE COMPANY INDIANA, INC. |
Centene Corporation | Provider Services | 8662968731 | 68472 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1723 - ABSOLUTE TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8664336041 | 68471 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Health Net | 8008676564 | 68470 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1436 - ABSOLUTE TOTAL CARE, INC. |
Centene Corporation | 68469 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H1416 - HARMONY HEALTH PLAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68468 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1395 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8667960530 | 68467 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | 68466 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H1215 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Health Net | 8008676564 | 68465 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1112 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68464 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H1032 - Sunshine State Health Plan, Inc. |
Centene Corporation | Website Inquiries | 8888889355 | 68463 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE |
Centene Corporation | 68462 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68461 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 68460 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Member Services | 8663897690 | 68459 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0712 - WELLCARE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68458 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0562 - HEALTH NET OF CALIFORNIA, INC. |
Centene Corporation | Provider Services | 8002754737 | 68457 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0482 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | 68456 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
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H0480 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Member Services | 8553234578 | 68455 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0351 - HEALTH NET OF ARIZONA, INC. |
Centene Corporation | Provider Services | 8009777522 | 68454 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0270 - WELLCARE HEALTH INSURANCE COMPANY OF AMERICA |
Centene Corporation | Website Inquiries | 8888889355 | 68453 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0174 - WELLCARE OF TEXAS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68452 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0111 - WELLCARE OF GEORGIA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68451 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | 68450 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf | ||
|
H0074 - WELLCARE OF MISSISSIPPI, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 68449 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0062 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 68448 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0029 - COORDINATED CARE OF WASHINGTON, INC. |
Centene Corporation | Health Net | 8008676564 | 68447 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H0022 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 68446 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf |
|
H2537 - ALBRIGHT CARE SERVICES |
SpiritTrust Lutheran | 68113 | 29-APR-2022 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain fiscal soundness | 68113_l1h1_04292022121412325_1.H2537 CAP.pdf | ||
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H0839 - VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC |
Volunteers of America National Services | Antionette Hively | 9194253000 | 68112 | 29-APR-2022 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain fiscal soundness | 68112_l1h1_04292022121152579_1.H0839 CAP.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 67969 | 01-APR-2022 | Drug Benefit | OMS | Failure to comply with the Part D DMP coverage limitation requirements | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 67968 | 01-APR-2022 | Drug Benefit | OMS | Failure to disclose data to CMS in accordance with Part D DMP requirements | Ad-Hoc CAP-letter.pdf | ||
|
H3362 - INDEPENDENT HEALTH ASSOCIATION, INC. |
Independent Health Association, Inc. | Member Services | 8006651502 | 67653 | 04-MAR-2022 | Drug Benefit | Benefit Administration | Failure to Administer CY 2022 Benefit as Approved | Ad-Hoc CAP-letter.pdf |
|
H3344 - INDEPENDENT HEALTH BENEFITS CORPORATION |
Independent Health Association, Inc. | Member Services | 8006651502 | 67652 | 04-MAR-2022 | Drug Benefit | Benefit Administration | Failure to Administer CY 2022 Benefit as Approved | Ad-Hoc CAP-letter.pdf |
|
H8280 - BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. H8364 - BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. |
Bright Health Group, Inc. | 67847 * | 02-MAR-2022 | Health and Drug Benefit | Other | BHIC failed to adhere to CMS' change of ownership requirements and did not ensure that BHIC was approved to operate in all service areas. | 67847_l1h1_03022022112647376_1.CAP_H8280 H8364.pdf | ||
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H9706 - HCSC INSURANCE SERVICES COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 67649 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9589 - CLEAR SPRING HEALTH (GA), INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 67648 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | 67647 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | 67646 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5015 - TEXAS INDEPENDENCE HEALTH PLAN, INC. |
Regency ISNP Holdings LLC | Customer Service | 8334718447 | 67645 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2793 - IMPERIAL INSURANCE COMPANIES INC. |
Imperial Health Plan of California | 67644 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2678 - MoreCare, Inc. |
MHNU Corporation | 67643 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H1947 - COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 67642 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S8182 - AMERIGROUP INSURANCE COMPANY |
Elevance Health, Inc. | 67641 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S6946 - CLEAR SPRING HEALTH INSURANCE COMPANY |
Group 1001 | Elizabeth Cuevas | 7542085880 | 67640 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8293 - CLEAR SPRING HEALTH (VA), INC. |
Group 1001 | 67639 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6379 - CLEAR SPRING HEALTH (CO), INC. |
Group 1001 | Elizabeth Cuevas | 7542085880 | 67638 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7322 - OSCAR HEALTH PLAN OF NEW YORK, INC. |
Oscar Health, Inc. | 67637 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 67636 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5496 - IMPERIAL HEALTH PLAN OF CALIFORNIA, INC. |
Imperial Health Plan of California | Erica Ruiz | 8007087903 | 67635 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | 67634 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1924 - LASSO HEALTHCARE INSURANCE COMPANY |
Port Holdings, Inc. | 67633 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
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H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 67632 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Member Services | 8663897690 | 67631 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S7126 - OMAHA HEALTH INSURANCE COMPANY |
Mutual of Omaha Insurance Company | 67630 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S5609 - ASURIS NORTHWEST HEALTH |
Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 67629 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S3285 - MG INSURANCE COMPANY |
MedImpact Holdings, Inc. | Customer Service | 8448263451 | 67628 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S1894 - COMMUNITYCARE GOVERNMENT PROGRAMS, INC. |
St Francis Health System & St John Health System | 67627 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8764 - ASPIRE HEALTH PLAN |
Montage Health | Customer Service | 8555701600 | 67626 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8554 - GHS INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 67625 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5273 - CAREPARTNERS OF CONNECTICUT, INC. |
Point32Health, Inc. | Kenneth Kayser | 7816121000 | 67624 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4093 - PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC |
Rifkin Managed Care Holding, LLC | Sue Radice | 4109913213 | 67623 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | 67622 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2793 - IMPERIAL INSURANCE COMPANIES INC. |
Imperial Health Plan of California | 67621 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2400 - SIGNATURE ADVANTAGE, LLC |
SA Plan, LLC | Shawna Hearing | 8442148633 | 67620 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 67619 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0982 - SOLIS HEALTH PLANS, INC. |
Athena Healthcare Holdings, LLC | Provider Services | 8336159259 | 67618 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 67617 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4922 - AGEWELL NEW YORK, LLC |
ParkerCare New York, LLC | 67616 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4853 - BRIGHT HEALTH COMPANY OF ARIZONA |
Bright Health Group, Inc. | 67615 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 67614 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1436 - ABSOLUTE TOTAL CARE, INC. |
Centene Corporation | 67613 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7680 - PROMINENCE HEALTHFIRST OF TEXAS |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 67612 | 25-FEB-2022 | Health and Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5596 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 67330 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Submit CY 2022 Crosswalk by Bid Deadline | Ad-Hoc CAP-letter.pdf |
|
H5141 - CLOVER INSURANCE COMPANY |
Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 66988 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions, Resulting in Plan Correction(s) | Ad-Hoc CAP-letter.pdf |
|
H1248 - LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY |
Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 66987 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions, Resulting in Plan Correction(s) | Ad-Hoc CAP-letter.pdf |
|
H2986 - Essence Healthcare of California, Inc. |
Lumeris Group Holdings Corporation | 66769 * | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions | Ad-Hoc CAP-letter.pdf | ||
|
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | 64113 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf | ||
|
H3204 - PRESBYTERIAN HEALTH PLAN |
Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 64112 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf |
|
H5211 - SECURITY HEALTH PLAN OF WISCONSIN, INC. |
Marshfield Clinic Health System, Inc. | Ken Baur | 7152219556 | 64111 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf |
|
H0545 - INTER VALLEY HEALTH PLAN, INC. |
InterValley Health Plan | 64110 * | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf | ||
|
H0490 - MOLINA HEALTHCARE OF OHIO, INC. H9595 - MOLINA HEALTHCARE OF VIRGINIA, INC. |
Molina Healthcare, Inc. | 63550 * | 14-JAN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio (MLR) data. | 63550_th5f_01102022172001671_1.Ad-Hoc CAP Molina Healthcare Inc. H0490_H9595.pdf | ||
|
H0150 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY H2165 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H3945 - CIGNA HEALTH AND LIFE INSURANCE COMPANY H4454 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 63551 * | 12-JAN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio (MLR) data. | 63551_th5f_02092022154444434_1.Ad-Hoc CAP Cigna_H0150_H2165_H3945_ H4454_ H4528_ H6972sig.pdf | ||
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H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. H5628 - MOLINA HEALTHCARE OF UTAH, INC. H5810 - MOLINA HEALTHCARE OF CALIFORNIA H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. H7678 - MOLINA HEALTHCARE OF TEXAS, INC. H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898, 8006651029, 8886651328 | 63434 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio data. | Ad-Hoc CAP-letter.pdf |
|
H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. H1415 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H2108 - BRAVO HEALTH MID-ATLANTIC, INC. H3949 - BRAVO HEALTH PENNSYLVANIA, INC. H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4513 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H5410 - HEALTHSPRING OF FLORIDA, INC. H7020 - CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H9460 - CIGNA HEALTHCARE OF ST LOUIS, INC. H9725 - CIGNA HEALTHCARE OF NORTH CAROLINA, INC. S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
The Cigna Group | Jared Rich, Russ Meadows | 8002226700, 8006683813 | 63433 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2016, CY 2017 and CY 2018 reporting year. | Ad-Hoc CAP-letter.pdf |
|
H0571 - CHINESE COMMUNITY HEALTH PLAN |
Chinese Hospital Association | Youngsoo Cho | 6282283375 | 63432 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2018 reporting year | Ad-Hoc CAP-letter.pdf |
|
S5805 - UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK S5820 - UNITEDHEALTHCARE INSURANCE COMPANY S8841 - OPTUM INSURANCE OF OHIO, INC. |
UnitedHealth Group, Inc. | Todd Summers, UHC Customer Service | 8664431095, 8888675575 | 62532 | 06-AUG-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H3204 - PRESBYTERIAN HEALTH PLAN H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 62576 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H1463 - HEALTH ALLIANCE CONNECT, INC. H1737 - HEALTH ALLIANCE - MIDWEST, INC. H2591 - HEALTH ALLIANCE - MIDWEST, INC. H3471 - HEALTH ALLIANCE NORTHWEST HEALTH PLAN S4219 - HEALTH ALLIANCE MEDICAL PLANS |
The Carle Foundation | Jennifer Marquardt | 2179029229 | 62575 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
S2668 - MEMBERS HEALTH INSURANCE COMPANY |
Tennessee Rural Health Improvement Association | Tracy Ring | 8339990135 | 62574 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H2563 - SENTARA HEALTH PLANS |
Sentara Health Care (SHC) | OPTIMA MEMBER SERVICES | 8009276048 | 62573 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H3811 - SAMARITAN HEALTH PLANS, INC. |
Samaritan Health Services | Janice Crayk | 5417685192 | 62572 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H8578 - HEALTH NEW ENGLAND, INC. |
Baystate Health, Inc. | Member Services | 8774433314 | 62571 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H0524 - KAISER FOUNDATION HP, INC. H0630 - KAISER FOUNDATION HP OF CO H1170 - KAISER FOUNDATION HP OF GA, INC. H1230 - KAISER FOUNDATION HP, INC. H2150 - KAISER FNDN HP OF THE MID-ATLANTIC STS H2172 - KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES H5050 - KAISER FOUNDATION HEALTH PLAN OF WASHINGTON H9003 - KAISER FOUNDATION HP OF THE N W |
Kaiser Foundation Health Plan, Inc. | Allison Anderson, Member Services, Provider Assistance Unit | 3018166481, 8002324440, 8004430815, 8004762167, 8772218221, 8887674670 | 62570 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H3909 - QCC INSURANCE COMPANY H3952 - KEYSTONE HEALTH PLAN EAST, INC. S6875 - QCC INSURANCE COMPANY |
Independence Health Group, Inc. | Customer Service | 8006453965, 8886787009, 8887183333 | 62569 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H1660 - HARVARD PILGRIM HEALTH CARE, INC. H6750 - HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. |
Point32Health, Inc. | 62568 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf | ||
|
E3014 - PSERS HOP PROGRAM |
Commonwealth of PA Pub Schools Retirement System | PSERS HOP Administration Unit | 7173057388 | 62567 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H0354 - CIGNA HEALTHCARE OF ARIZONA, INC. H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. H1415 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H2108 - BRAVO HEALTH MID-ATLANTIC, INC. H3949 - BRAVO HEALTH PENNSYLVANIA, INC. H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4513 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H5410 - HEALTHSPRING OF FLORIDA, INC. H7020 - CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H8423 - Molina Healthcare of Texas, Inc. H9460 - CIGNA HEALTHCARE OF ST LOUIS, INC. H9725 - CIGNA HEALTHCARE OF NORTH CAROLINA, INC. S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
The Cigna Group | Jared Rich, Mike Soltis, Russ Meadows | 8002226700, 8006683813 | 62566 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H5859 - HEALTH PLAN OF CAREOREGON, INC. |
CareOregon, Inc. | Whitney Duran Rey | 5034168040 | 62565 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H5587 - HEALTH CHOICE ARIZONA, INC. |
Blue Cross Blue Shield of Arizona | Member Services | 8006568991 | 62564 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf |
|
H2793 - IMPERIAL INSURANCE COMPANIES INC. |
Imperial Health Plan of California | 62410 * | 29-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to hold proper license. | 62410_mn03_06292021110632889_1.Imperial_CAP_Final_Revised.pdf | ||
|
S5596 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 62319 | 10-JUN-2021 | Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf |
|
H9207 - HEALTH PARTNERS PLANS, INC. |
Thomas Jefferson University | Sarah Grzyb | 6098657999 | 62318 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf |
|
H3388 - CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. H5042 - CDPHP UNIVERSAL BENEFITS, INC. |
Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 8009267526 | 62316 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf |
|
H3471 - HEALTH ALLIANCE NORTHWEST HEALTH PLAN |
The Carle Foundation | 62317 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf | ||
|
H8764 - ASPIRE HEALTH PLAN |
Montage Health | Customer Service | 8555701600 | 62363 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | 62363_mn03_06112021070059725_1.H8764 - Aspire Health Plan _CAP_Fiscal Soundness _06-09-2021.pdf |
|
H2537 - ALBRIGHT CARE SERVICES |
SpiritTrust Lutheran | 62359 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | 62359_mn03_06112021065418112_1.H2537 - Spiritrust Lutheran Life _ CAP _ Fiscal Soundness_06-09- 2021.pdf | ||
|
H0839 - VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC |
Volunteers of America National Services | Antionette Hively | 9194253000 | 62360 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | 62360_mn03_06112021065640104_1.H0839 - VOANS Senior Community Care of NC PACE_ CAP _ Fiscal Soundness_ 06-09-2021.pdf |
|
H3809 - PROVIDENCE HEALTH & SERVICES - OREGON |
Providence Health & Services | Rika Bering | 5032156556 | 61930 | 15-JAN-2021 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2021 Formulary Requirements | Ad-Hoc CAP-letter.pdf |
|
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. |
Vitality Health Plans, Inc. | Member Services | 8663333530 | 61349 | 13-NOV-2020 | Health Benefit | Network adequacy - Health | Failure to meet network adequacy requirements. | 61349_mn03_11132020103332553_1.H1426_Vitality_Network_Adequacy_CAP.pdf |
|
H2610 - ESSENCE HEALTHCARE, INC. |
Lumeris Group Holdings Corporation | Customer Service | 8665979560 | 59068 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf |
|
H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 59067 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf |
|
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. |
Vitality Health Plans, Inc. | Member Services | 8663333530 | 59066 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf |
|
H5042 - CDPHP UNIVERSAL BENEFITS, INC. |
Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 8009267526 | 59065 | 22-MAY-2020 | Drug Benefit | Bid Submission | Failure to comply with CY2020 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
H3388 - CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. |
Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 8009267526 | 59064 | 22-MAY-2020 | Drug Benefit | Bid Submission | Failure to comply with CY2020 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
H7119 - PROVIDER PARTNERS HEALTH PLAN OF OHIO |
Rifkin Managed Care Holding, LLC | 57184 * | 06-SEP-2019 | Health Benefit | Network adequacy - Health | Failed to have an adequate network. | 57184_mn03_09092019103302827_1.Provider Partners Health Plan_H7119_CAP_9_6_19_revised.pdf | ||
|
S4607 - MERIT HEALTH INSURANCE COMPANY |
Magellan Health, Inc. | 55590 * | 29-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H6672 - CLEAR SPRING HEALTH (GA), INC. |
Eon Health Plan, LLC | Elizabeth Cuevas | 7542085880 | 55589 | 29-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK |
The Cigna Group | 54819 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S2668 - MEMBERS HEALTH INSURANCE COMPANY |
Tennessee Rural Health Improvement Association | Tracy Ring | 8339990135 | 54818 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9870 - Justify Holdings, Inc. |
University Health Care, Inc. | 54817 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H9153 - WEST VIRGINIA SENIOR ADVANTAGE, INC. |
SNP Holdings LLC | Carole Piper | 5136056845 | 54816 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
University of Maryland Medical System Corporation | Member Services | 8443866762 | 54815 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7173 - PEACH STATE HEALTH PLAN, INC. |
Centene Corporation | 54814 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
Elevance Health, Inc. | 54812 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE |
Banner Health | Customer Care | 5208743930 | 54811 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3928 - AETNA HEALTH INC. (LA) |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 54810 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. |
Family Health Network | Elizabeth Cuevas | 7542085880 | 54808 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. |
Molina Healthcare, Inc. | 54807 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54806 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1587 - ARKANSAS SUPERIOR SELECT, INC. |
Select Founders, LLC | Customer Service | 5013721922 | 54804 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0174 - WELLCARE OF TEXAS, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54803 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 54802 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8133 - GHS INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 54801 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6743 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 54799 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5991 - HEALTH INSURANCE PLAN OF GREATER NEW YORK |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 54798 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 54797 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5945 - PROMINENCE HEALTHFIRST |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 54796 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5587 - HEALTH CHOICE ARIZONA, INC. |
Steward Health Care System, LLC | Member Services | 8006568991 | 54795 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5435 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8665798774 | 54794 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA |
Elevance Health, Inc. | Customer Service | 8882307338 | 54793 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4922 - AGEWELL NEW YORK, LLC |
ParkerCare New York, LLC | 54792 * | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4388 - SECURITY HEALTH PLAN OF WISCONSIN, INC. |
Marshfield Clinic Health System, Inc. | 54791 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H4213 - USABLE MUTUAL INSURANCE COMPANY |
USAble Mutual Insurance Company | Customer Service | 8442014934 | 54790 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. |
Health Care Service Corporation | Customer Service | 8778956448 | 54789 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. |
Presbyterian Healthcare Services | 54788 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H2773 - QUALITY HEALTH PLANS OF NEW YORK, INC. |
QHP Financial Group, Inc. | 54787 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H1737 - HEALTH ALLIANCE - MIDWEST, INC. |
The Carle Foundation | Jennifer Marquardt | 2179029229 | 54786 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1181 - NETWORK HEALTH INSURANCE CORPORATION |
Network Health, Inc. | Customer Service | 8003785234 | 54785 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 54784 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54783 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. |
Friday Health Plans, Inc. | 54782 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 54781 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
The Cigna Group | Russ Meadows | 8002226700 | 54780 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9403 - CLEAR SPRING HEALTH (SC), INC. |
Group 1001 | 54779 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H7680 - PROMINENCE HEALTHFIRST OF TEXAS |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 54778 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8554 - GHS INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 54777 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8506 - MODA HEALTH PLAN, INC. |
Moda Partners, Inc. | 54776 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf | ||
|
H8298 - HORIZON HEALTHCARE OF NEW JERSEY, INC. |
Horizon Mutual Holdings, Inc | Suze Mestres | 9734665503 | 54775 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6396 - CARESOURCE OHIO, INC. |
CareSource | Bobby Pace | 9375312060 | 54774 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6988 - CENTERS PLAN FOR HEALTHY LIVING, LLC |
Centers Plan for Healthy Living, LLC | Natalie Fernandes | 7182157000 | 54800 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 54805 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2459 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 53704 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 53709 | 28-FEB-2019 | Drug Benefit | Formulary Submission and Administration | Failure to properly implement the required Transition Policy | Ad-Hoc CAP-letter.pdf | ||
|
H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 53708 | 28-FEB-2019 | Drug Benefit | Formulary Submission and Administration | Failure to properly implement the required Transition Policy | Ad-Hoc CAP-letter.pdf |
|
S4219 - HEALTH ALLIANCE MEDICAL PLANS |
The Carle Foundation | 53721 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf | ||
|
S5609 - ASURIS NORTHWEST HEALTH |
Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 53722 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
S5916 - REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH |
Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 53723 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
S9701 - DEAN HEALTH INSURANCE, INC. |
SSM Health Care Corporation | Scott Jacoby | 9202214087 | 53724 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
S1894 - COMMUNITYCARE GOVERNMENT PROGRAMS, INC. |
St Francis Health System & St John Health System | 52561 * | 02-JAN-2019 | Drug Benefit | 4Rx Submission and Accuracy Problems | PCN/BIN must be completed for 99% of all enrollments | Ad-Hoc CAP-letter.pdf | ||
|
H7971 - HORIZON INSURANCE COMPANY |
Horizon Mutual Holdings, Inc | 51478 * | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf | ||
|
H3815 - ALIGNMENT HEALTH PLAN |
Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 51473 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H0104 - BLUE CROSS AND BLUE SHIELD OF ALABAMA |
BlueCross BlueShield of Alabama | Jeff Corley | 8005176425 | 51469 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 51472 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H7220 - INDIANA UNIVERSITY HEALTH PLANS NFP, INC. |
Indiana University Health | Nina Barrow | 8004559776 | 51476 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H1170 - KAISER FOUNDATION HP OF GA, INC. |
Kaiser Foundation Health Plan, Inc. | Member Services | 8002324440 | 51471 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H9576 - NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND |
NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND | Lisa Carcieri | 4014596008 | 51479 | 02-NOV-2018 | Drug Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H0423 - METROPLUS HEALTH PLAN, INC. |
New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 51470 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H5386 - SHARP HEALTH PLAN |
Sharp Healthcare | Leslie Pels-Beck | 8584998244 | 51474 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H5945 - PROMINENCE HEALTHFIRST |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 51475 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
H7680 - PROMINENCE HEALTHFIRST OF TEXAS |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 51477 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf |
|
S5753 - WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION |
Wisconsin Physicians Service Ins Corporation. | 51480 * | 02-NOV-2018 | Drug Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf | ||
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 52042 | 18-OCT-2018 | Health and Drug Benefit | Call Center Requirements | See attachment | 52042_th5f_11232018145242071_1.H1189_CAP_Interpreter Availability_2018.pdf |
|
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION |
Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 52041 | 18-OCT-2018 | Drug Benefit | Call Center Requirements | See attachment | 52041_th5f_11232018144741896_1.S5877_CAP_Interpreter Availability_2018.pdf |
|
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. |
Health Care Service Corporation | Customer Service | 8778956448 | 48606 | 28-FEB-2018 | Drug Benefit | 4Rx Submission and Accuracy Problems | CAP is requested when errors remain after Warninig letter is sent. | Ad-Hoc CAP-letter.pdf |
|
H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 48651 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf |
|
S5601 - SILVERSCRIPT INSURANCE COMPANY |
CVS Health Corporation | Kelly Devine | 8662355660 | 48652 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 48654 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf | ||
|
H1977 - UPPER PENINSULA HEALTH PLAN, LLC |
DLP Marquette General Hospital, LLC | Nicole Stewart | 9062251177 | 48655 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf |
|
H5141 - CLOVER INSURANCE COMPANY |
Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 48686 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
H9047 - PROVIDENCE HEALTH ASSURANCE |
Providence Health & Services | Misty Dunphy | 5035746608 | 48687 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
S8899 - TAKECARE INSURANCE COMPANY, INC. |
TakeCare Health Systems | 48688 * | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf | ||
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | 48689 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf | ||
|
S5795 - USABLE MUTUAL INSURANCE COMPANY |
USAble Mutual Insurance Company | Customer Service | 8442014934 | 48690 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf |
|
H1099 - HEALTH FIRST HEALTH PLANS |
Health First Shared Services, Inc. | Katie Fleming | 8445225282 | 48202 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 48203 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H1394 - HMO COLORADO, INC. |
Elevance Health, Inc. | 48204 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H1517 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | 48205 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H1607 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48306 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. |
Elevance Health, Inc. | 48307 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48308 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2224 - SENIOR WHOLE HEALTH, LLC |
Magellan Health, Inc. | Member Services | 8006650898 | 48309 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2230 - BCBS OF MASSACHUSETTS HMO BLUE, INC. |
Blue Cross and Blue Shield of Massachusetts, Inc. | Member Services | 8002004255 | 48310 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2261 - BCBS OF MASSACHUSETTS HMO BLUE, INC. |
Blue Cross and Blue Shield of Massachusetts, Inc. | Member Services | 8002004255 | 48311 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2320 - PRIORITY HEALTH |
Corewell Health | Customer Service | 8883896648 | 48312 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2456 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 48313 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H2459 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 48314 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3233 - PREMIER HEALTH INSURING CORPORATION |
Premier Health Partners | 48315 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H3240 - WELLPOINT NEW JERSEY, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48316 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3259 - VOLUNTEER STATE HEALTH PLAN |
BlueCross BlueShield of Tennessee | Customer Service | 8002991407 | 48317 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3330 - HEALTH INSURANCE PLAN OF GREATER NEW YORK |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 48318 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3335 - EXCELLUS HEALTH PLAN, INC. |
Lifetime Healthcare, Inc. | Brittani Ihle | 7165045556 | 48319 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3342 - ANTHEM HEALTHCHOICE ASSURANCE, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48320 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3351 - EXCELLUS HEALTH PLAN, INC. |
Lifetime Healthcare, Inc. | Brittani Ihle | 7165045556 | 48321 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3370 - EMPIRE HEALTHCHOICE HMO, INC. |
Elevance Health, Inc. | 48322 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H3384 - Highmark Western and Northeastern New York Inc. |
HealthNow New York Inc. | Customer Service | 8773271395 | 48323 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3447 - HEALTHKEEPERS, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48324 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3528 - CONNECTICARE, INC. |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 48325 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3536 - MATTHEW THORNTON HEALTH PLAN, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48326 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3655 - COMMUNITY INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 48327 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3672 - THE HEALTH PLAN OF WEST VIRGINIA, INC. |
The Health Plan of West Virginia, Inc. | Penny Richard | 7406957597 | 48328 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3907 - UPMC HEALTH PLAN, INC. |
UPMC Health System | Medicare Marketing | 8773813765 | 48329 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3916 - HIGHMARK SENIOR HEALTH COMPANY |
Highmark Health | Provider Service | 8665886967 | 48330 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H3957 - HIGHMARK CHOICE COMPANY |
Highmark Health | Provider Service | 8665886967 | 48331 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H4036 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48332 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H4279 - UPMC FOR YOU, INC |
UPMC Health System | Medicare Marketing | 8773813765 | 48333 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H4497 - MEDICAL MUTUAL OF OHIO |
MEDICAL MUTUAL OF OHIO | Shirra Subsinsky | 8003621279 | 48334 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H4875 - PRIORITY HEALTH |
Corewell Health | Customer Service | 8883896648 | 48335 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H4909 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48336 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5106 - HIGHMARK SENIOR SOLUTIONS COMPANY |
Highmark Health | Provider Service | 8665886967 | 48337 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5215 - NETWORK HEALTH INSURANCE CORPORATION |
Network Health, Inc. | Customer Service | 8003785234 | 48338 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA |
Elevance Health, Inc. | Customer Service | 8882307338 | 48339 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5425 - SCAN HEALTH PLAN |
SCAN Health Plan | Kim McBeath | 8777787226 | 48340 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5471 - SIMPLY HEALTHCARE PLANS, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48341 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5526 - Highmark Western and Northeastern New York Inc. |
HealthNow New York Inc. | Customer Service | 8773271395 | 48342 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. |
Elevance Health, Inc. | 48343 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H5533 - UPMC HEALTH NETWORK, INC. |
UPMC Health System | Medicare Marketing | 8773813765 | 48344 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
Elevance Health, Inc. | 48345 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H5817 - AMERIGROUP TEXAS, INC. |
Elevance Health, Inc. | 48346 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON |
Community Health Plan of Washington | Customer Care | 8009420247 | 48347 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5854 - ANTHEM HEALTH PLANS, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48348 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5937 - UCARE MINNESOTA |
UCare Minnesota | Jennifer Pena | 6122945251 | 48350 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5943 - SCAN HEALTH PLAN |
SCAN Health Plan | Kim McBeath | 8777787226 | 48351 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 48352 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H5992 - SENIOR WHOLE HEALTH OF NEW YORK, INC. |
Magellan Health, Inc. | Member Services | 8006650898 | 48353 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H6229 - BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. |
Elevance Health, Inc. | 48354 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H6298 - MEDICAL MUTUAL OF OHIO |
MEDICAL MUTUAL OF OHIO | 48355 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H6453 - HMO LOUISIANA, INC. |
Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 48356 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H6723 - MEDICAL MUTUAL OF OHIO |
MEDICAL MUTUAL OF OHIO | Shirra Subsinsky | 8003621279 | 48357 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H6786 - ANTHEM HEALTH PLANS OF MAINE, INC. |
Elevance Health, Inc. | 48358 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H6864 - GUILDNET, INC. |
Jewish Guild for the Blind | 48359 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H7200 - AMERIGROUP TENNESSEE, INC. |
Elevance Health, Inc. | 48360 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H7728 - ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. |
Elevance Health, Inc. | 48361 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H7917 - BLUECROSS BLUESHIELD OF TENNESSEE, INC. |
BlueCross BlueShield of Tennessee | Customer Service | 8008312583 | 48362 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H8146 - SECURITYCARE OF TENNESSEE, INC. |
BlueCross BlueShield of Tennessee | 48363 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H8289 - BAPTIST HEALTH PLAN, INC. |
Baptist Healthcare System | 48364 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H8432 - ANTHEM HEALTHCHOICE HMO, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48365 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 48366 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H8604 - THP INSURANCE COMPANY |
The Health Plan of West Virginia, Inc. | Penny Richard | 7406957597 | 48367 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H8786 - WEllPOINT TEXAS, INC. |
Elevance Health, Inc. | 48368 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H8851 - SENIOR WHOLE HEALTH OF NEW YORK, INC. |
Magellan Health, Inc. | 48369 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9104 - SCAN HEALTH PLAN |
SCAN Health Plan | 48370 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9487 - MICHIGAN COMPLETE HEALTH, INC. |
Centene Corporation | 48371 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9525 - COMPCARE HEALTH SERVICES INSURANCE CORPORATION |
Elevance Health, Inc. | Customer Service | 8882307338 | 48372 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H9886 - HMO MISSOURI, INC. |
Elevance Health, Inc. | 48374 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9915 - MEDSTAR FAMILY CHOICE, INC. |
Medstar Health, Inc. | 48375 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. |
Elevance Health, Inc. | 48376 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H9954 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | 48377 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
R5941 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48378 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
S5593 - HM HEALTH INSURANCE COMPANY |
Highmark Health | Provider Service | 8665886967 | 48380 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
S5596 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 48381 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
S5660 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
Express Scripts Holding Company | Customer Service | 8007584574 | 48382 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
S5726 - BLUE CROSS AND BLUE SHIELD OF KANSAS |
Blue Cross Blue Shield of Kansas | Customer Service | 8882307338 | 48383 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
S5753 - WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION |
Wisconsin Physicians Service Ins Corporation. | 48384 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION |
Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 48385 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf |
|
H0811 - GUILDNET, INC. |
Jewish Guild for the Blind | 48201 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H0735 - UCARE MINNESOTA |
UCare Minnesota | 48200 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H0564 - BLUE CROSS OF CALIFORNIA |
Elevance Health, Inc. | 48199 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
H0147 - HEALTHKEEPERS, INC. |
Elevance Health, Inc. | 48198 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK |
Express Scripts Holding Company | 48386 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf | ||
|
S5660 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK |
Express Scripts Holding Company | Customer Service | 8007584574 | 48197 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission. | Ad-Hoc CAP-letter.pdf |
|
H1189 - CHRISTUS HEALTH PLAN |
CHRISTUS Health | Ronda Hefton | 8442823026 | 47308 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47308_b5ws_12112017124501271_1.H1189_CAP.pdf |
|
H0148 - BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN |
California Physicians' Service | 47306 * | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47306_b5ws_12112017110155308_1.H0148_CAP.pdf | ||
|
H5928 - California Physicians' Service |
California Physicians' Service | Member Services | 8007764466 | 47387 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47387_th5f_12152017114730423_1.H5928_CAP.pdf |
|
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. |
Colorado Choice Health Plans | 47307 * | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47307_b5ws_12112017124148254_1.H0657_CAP.pdf | ||
|
H5938 - CAPITAL HEALTH PLAN |
Guidewell Mutual Holding Corporation | Beth Maige | 8505237307 | 47388 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47388_th5f_12152017115418979_1.H5938_CAP.pdf |
|
H9712 - HAP CareSource |
Henry Ford Health System | Bobby Pace | 9375312060 | 47391 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47391_th5f_12152017144212526_1.H9712_CAP_ Updated_CAM ID 47391.pdf |
|
H2237 - INDEPENDENT CARE HEALTH PLAN |
Independent Care Health Plan Inc. | Lisa Richter | 8004486262 | 47309 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47309_b5ws_12112017125049068_1.H2237_CAP.pdf |
|
H0332 - KS PLAN ADMINISTRATORS, LLC |
Kelsey-Seybold Medical Group, PLLC | Member Services | 8665358343 | 47326 | 08-DEC-2017 | Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47326_b5ws_01042018085101870_1.H0332_CAP_CAM ID 47326.pdf |
|
H3706 - GLOBALHEALTH, INC. |
MHH Healthcare, L.P. | Daniel Thomas | 4055261126 | 47386 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47386_th5f_12152017113901420_1.H3706_CAP.pdf |
|
H2458 - MEDICA HEALTH PLANS |
Medica Holding Company | Customer Service | 8002348755 | 47346 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47346_b5ws_12142017092029540_1.H2458_CAP.pdf |
|
H3653 - MEDICAL MUTUAL |
Promedica Health System, Inc. | Member Services | 8004623589 | 47367 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47367_th5f_12142017141756510_1.H3653_CAP.pdf |
|
H7890 - SANTA CLARA COUNTY HEALTH AUTHORITY |
SANTA CLARA COUNTY HEALTH AUTHORITY | 47389 * | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47389_th5f_12152017115657080_1.H7890_CAP.pdf | ||
|
H2986 - Essence Healthcare of California, Inc. |
Stanford Health Care | 47366 * | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47366_th5f_12142017135829881_1.H2986_CAP.pdf | ||
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
University of Maryland Medical System Corporation | Member Services | 8443866762 | 47390 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | 47390_th5f_12152017115944366_1.H8854_CAP.pdf |
|
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Caidan Enterprises, Inc. | Provider Services | 8662968731 | 45621 | 06-JUL-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating for Part D. | Ad-Hoc CAP-letter.pdf |
|
H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 45622 * | 06-JUL-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating for Part C. | Ad-Hoc CAP-letter.pdf | ||
|
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE |
Banner Health | Customer Care | 5208743930 | 45504 | 14-JUN-2017 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2017 Inaccurate ANOC/EOC | 45504_d4z8_06152017130746948_1.H4931_AdHocCAP_2017_ANOCEOC_Inaccurate.pdf |
|
H8237 - INSURANCE COMPANY OF SCOTT AND WHITE |
Baylor Scott & White Holdings | 45531 * | 14-JUN-2017 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2017 Inaccurate ANOC/EOC | 45531_d4z8_06152017130911152_1.H8237_AdHocCAP_2017_ANOCEOC_Inaccurate.pdf | ||
|
E7316 - UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS |
Union Pacific Railroad Employes Health Systems | 45263 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H0490 - MOLINA HEALTHCARE OF OHIO, INC. |
Molina Healthcare, Inc. | 45264 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. |
Colorado Choice Health Plans | 45265 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45266 | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H1264 - WELLCARE OF TEXAS, INC. |
WellCare Health Plans, Inc. | 45267 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H1416 - HARMONY HEALTH PLAN, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45268 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. |
Family Health Network | Elizabeth Cuevas | 7542085880 | 45270 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H3347 - ELDERPLAN, INC. |
Elderplan, Inc. | Doretha Alston | 7189217979 | 45271 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H3361 - WELLCARE OF NEW YORK, INC. |
WellCare Health Plans, Inc. | 45272 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H3945 - CIGNA HEALTH AND LIFE INSURANCE COMPANY |
The Cigna Group | 45273 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. |
Health Care Service Corporation | Customer Service | 8778956448 | 45274 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H3154 - HORIZON INSURANCE COMPANY |
Horizon Mutual Holdings, Inc | 45275 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H5087 - WELLCARE OF CALIFORNIA, INC. |
WellCare Health Plans, Inc. | Provider Services | 8662968731 | 45276 | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H5549 - VNS CHOICE |
Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 45277 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H5685 - HAP MIDWEST HEALTH PLAN, INC. |
Henry Ford Health System | 45278 * | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H5945 - PROMINENCE HEALTHFIRST |
Universal Health Services, Inc. | Libby Belli | 7757709450 | 45280 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H5991 - HEALTH INSURANCE PLAN OF GREATER NEW YORK |
Affinity Health Services Holdings, Inc. | Priyank Pandey | 6464477543 | 45281 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H6298 - MEDICAL MUTUAL OF OHIO |
MEDICAL MUTUAL OF OHIO | 45282 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. |
Health Care Service Corporation | 45283 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. |
Humana Inc. | 45301 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Jared Rich | 8006683813 | 45303 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H8266 - CONSTELLATION HEALTH, LLC. |
Constellation Health, LLC. | 45304 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H8634 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8778956448 | 45305 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H9190 - GATEWAY HEALTH PLAN OF OHIO, INC. |
Gateway Health, LLC. | 45306 * | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. |
Elevance Health, Inc. | 45307 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
S0522 - SYMPHONIX HEALTH INSURANCE, INC. |
UnitedHealth Group, Inc. | 45308 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
S4802 - WELLCARE PRESCRIPTION INSURANCE, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45309 | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf |
|
H3054 - CONSTELLATION HEALTH, LLC. |
Constellation Health, LLC. | 45269 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf | ||
|
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE |
Banner Health | Customer Care | 5208743930 | 45221 | 19-MAY-2017 | Health and Drug Benefit | Bid Submission | University Care Advantage failed to provide any substantiation for there CY2017 Bid Submission. | 45221_n2wm_05252017142915960_1.Banner_CAP_5-19-2017.pdf |
|
H0028 - CHA HMO, INC. H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0336 - HUMANA HEALTH PLAN, INC. H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1291 - HUMANA INSURANCE COMPANY OF NEW YORK H1406 - HUMANA HEALTH PLAN, INC. H1418 - HUMANA INSURANCE COMPANY H1468 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H1510 - HUMANA INSURANCE COMPANY H1716 - HUMANA INSURANCE COMPANY H1906 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2486 - HUMANA MEDICAL PLAN OF UTAH, INC. H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H3480 - HUMANA HEALTH PLAN, INC. H3533 - HUMANA HEALTH COMPANY OF NEW YORK, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4145 - HUMANA REGIONAL HEALTH PLAN, INC. H4461 - CARITEN HEALTH PLAN INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H5216 - HUMANA INSURANCE COMPANY H5415 - HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. H5525 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H5619 - ARCADIAN HEALTH PLAN, INC. H5970 - HUMANA INSURANCE COMPANY OF NEW YORK H6609 - HUMANA INSURANCE COMPANY H6622 - HUMANA WI HEALTH ORGANIZATION INSURANCE CORP H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. H8145 - HUMANA INSURANCE COMPANY H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. H8953 - HUMANA HEALTH PLAN OF OHIO, INC. R5826 - HUMANA INSURANCE COMPANY S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. S5552 - HUMANA INSURANCE COMPANY OF NEW YORK S5884 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 42899 | 31-AUG-2016 | Drug Benefit | Marketing--Website and Social Media | During the 2015 plan year, Humana maintained for all of its Part D contracts three online sources of information concerning its network pharmacies: the pharmacy search tool (PST), the pharmacy directory search tool (PDST), and the annual price estimate tool (PET).\nWith the PST, beneficiaries could search for pharmacies in a particular portion of Humana's service area, while they could use the PDST to obtain PDF versions of network pharmacy lists for each of the states in Humana's service area. The PET offered beneficiaries the opportunity to select a pharmacy from among those listed in Humana's contracted Part D network and to receive information about the plan's negotiated prices for prescription drugs identified by the beneficiary. Each of these web-based pharmacy network information resources was out of compliance with Part D requirements during 2015. | 42899_l4yx_09272016133024450_1.Humana Pharmacy Website CAP August 31 2016.pdf |
|
H5141 - CLOVER INSURANCE COMPANY |
Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 42000 | 29-JUL-2016 | Health Benefit | Notification to CMS of Administrative Changes | Failure to submit change of ownership documents prior to transaction. | 42000_mn03_04192017073601618_1.Clover_H5141_CHOW_CAP_Final_Reissued_4_19_17.pdf |
|
H2322 - ALLIANCE HEALTH AND LIFE INSURANCE COMPANY |
Henry Ford Health System | Heather Spencer | 2487763808 | 41561 | 19-JUL-2016 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY2016 Inaccurate ANOC/EOC | 41561_d4z8_07192016131224241_1.H2322_AdHocCAP_2016_InaccurateANOCEOC_HandRcontracts_03182016.pdf |
|
H5007 - PROVIDENCE HEALTH & SERVICES – WASHINGTON |
Providence Health & Services | Rika Bering | 5032153857 | 41260 | 11-JUL-2016 | Drug Benefit | Payment Process | CMS is issuing this notice based on Providence's failure to comply with Part D program requirements regarding the timely submission of Prescription Drug Event (PDE) data to CMS. CMS has also issued to Providence under this contract ID a Notice of Non-compliance (NoNC) on September 3, 2014, and a Warning Letter (WL) on December 4, 2014, for similar instances of non-compliance. For fourth quarter of 2014, the sponsor missed the November submission, making it the third quarter in a rom with missing submissions. | 41260_l4yx_07132016065400068_1.H5007 Providence Health System CAP PDE Submissions Q4 2014 emailed.pdf |
|
H3890 - HOPKINS HEALTH ADVANTAGE, INC. |
Johns Hopkins Healthcare LLC | Salma Riaz | 4107625905 | 41068 | 21-JUN-2016 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY2016 Inaccurate ANOC/EOC | 41068_d4z8_06232016081845139_1.H3890_AdHocCAP_2016_InaccurateANOCEOC_HandRcontracts_03182016.pdf |
|
H3312 - AETNA HEALTH INC. (NY) H5521 - AETNA LIFE INSURANCE COMPANY |
Aetna Inc. | Aetna Customer Service | 8006240756 | 38900 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38900_n2wm_03012016133110082_1.Aetna H3312 H5521 Initial Bid Submission san.pdf |
|
H0504 - CALIFORNIA PHYSICIANS' SERVICE |
California Physicians' Service | Member Services | 8007764466 | 38902 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38902_n2wm_03012016133736410_1.California Physicians' Service H0504 san.pdf |
|
H1304 - REGENCE BLUESHIELD OF IDAHO, INC. |
Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 38906 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38906_n2wm_03022016192608473_1.Regence Blue Shield of Idaho H1304 san.pdf |
|
S6311 - QUALCHOICE ADVANTAGE |
Catholic Health Initiatives | 38905 * | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38905_n2wm_03012016134919587_1.Qualchoice Advantage S6311 san.pdf | ||
|
H0107 - HEALTH CARE SERVICE CORPORATION H1666 - HCSC INSURANCE SERVICES COMPANY H8634 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8777748592, 8778956448 | 38903 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38903_n2wm_03012016134525645_1.Health Care Service Corp H0107 - H1666 - H8634 san.pdf |
|
H9207 - HEALTH PARTNERS PLANS, INC. |
Thomas Jefferson University | Sarah Grzyb | 6098657999 | 38904 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | 38904_n2wm_03012016134729061_1.Health Partners Plans Inc H9207 san.pdf |
|
H1493 - CARESOURCE KENTUCKY CO. H9162 - CARESOURCE INDIANA, INC. |
CareSource | 39621 * | 17-FEB-2016 | Health Benefit | Network adequacy - Health | On December 4, 2015, CareSource first notified CMS of significant errors in the HSD tables submitted during the MA application process. CMS used the inaccurate HSD tables to approve the application, specifically in the determination that the network was sufficient to meet the health care needs of beneficiaries in the defined service area. | 39621_m9n6_04022016141132345_1.CareSource Corrective Action Plan Final 02172016.pdf | ||
|
S5755 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 38723 * | 12-FEB-2016 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 38723_m5nx_02172016111420529_1.2016_4RxCAP_Letter_san.pdf | ||
|
H5302 - AETNA HEALTH INC. (GA) |
Aetna Inc. | Aetna Customer Service | 8006240756 | 38080 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38080_th5f_12102015104243942_1.H5302_CAP Letter for Low Star ratings.pdf |
|
H2174 - TRILLIUM COMMUNITY HEALTH PLAN, INC. |
Agate Resources, Inc. | Provider Services | 8448671156 | 38041 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38041_th5f_12092015111053245_1.H2174_CAP Letter for Low Star ratings.pdf |
|
H3815 - ALIGNMENT HEALTH PLAN |
Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 38053 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38053_th5f_12092015144218832_1.H3815_CAP Letter for Low Star ratings.pdf |
|
H9285 - ATLANTIS HEALTH PLAN, INC. |
America's 1st Choice NY Holdings, LLC | 38075 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38075_th5f_12102015132840955_1.H9285_CAP Letter for Low Star ratings.pdf | ||
|
H8237 - INSURANCE COMPANY OF SCOTT AND WHITE |
Baylor Scott & White Holdings | 38071 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38071_th5f_12102015130451549_1.H8237_CAP Letter for Low Star ratings.pdf | ||
|
S7230 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Caidan Enterprises, Inc. | 38083 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38083_th5f_12102015110338705_1.S7230_CAP Letter for Low Star ratings.pdf | ||
|
H5141 - CLOVER INSURANCE COMPANY |
Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 38065 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38065_th5f_12092015151759586_1.H5141_CAP Letter for Low Star ratings.pdf |
|
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. |
Colorado Choice Health Plans | 38036 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38036_b5ws_12092015085700998_1.H0657_CAP Letter for Low Star ratings.pdf | ||
|
H3054 - CONSTELLATION HEALTH, LLC. |
Constellation Health, LLC. | 38051 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38051_th5f_12092015143202214_1.H3054_CAP Letter for Low Star ratings.pdf | ||
|
H8266 - CONSTELLATION HEALTH, LLC. |
Constellation Health, LLC. | 38346 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38346_th5f_01142016112304736_1.H8266_CAP Letter for Low Star ratings.pdf | ||
|
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. |
Elevance Health, Inc. | 38072 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38072_th5f_12102015131120834_1.H9947_CAP Letter for Low Star ratings.pdf | ||
|
S0522 - SYMPHONIX HEALTH INSURANCE, INC. |
Granite Creek FlexCap LLP | 38073 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38073_th5f_12102015131553633_1.S0522_CAP Letter for Low Star ratings.pdf | ||
|
S5904 - BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. |
Guidewell Mutual Holding Corporation | Medicare Mbr Svcs | 8009266565 | 38084 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38084_th5f_12102015110701459_1.S5904_CAP Letter for Low Star ratings.pdf |
|
H1666 - HCSC INSURANCE SERVICES COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 38040 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38040_th5f_12092015104809698_1.H1666_CAP Letter for Low Star ratings.pdf |
|
H3251 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8778956448 | 38047 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38047_th5f_12092015125950707_1.H3251_CAP Letter for Low Star ratings.pdf |
|
H3822 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8778956448 | 38048 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38048_th5f_12092015130241780_1.H3822_CAP Letter for Low Star ratings.pdf |
|
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. |
Health Care Service Corporation | 38049 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38049_th5f_12092015130512837_1.H6801_CAP Letter for Low Star ratings.pdf | ||
|
S1140 - Highmark Western and Northeastern New York Inc. |
HealthNow New York Inc. | Customer Service | 8773271395 | 38076 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38076_th5f_12102015133202633_1.S1140_CAP Letter for Low Star ratings.pdf |
|
H3708 - OKLAHOMA SUPERIOR SELECT, INC. |
Healthcare Investors, LLC | Angie Brimm | 8665834649 | 38052 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38052_th5f_12092015143901067_1.H3708_CAP Letter for Low Star ratings.pdf |
|
S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | 38074 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38074_th5f_12102015132053295_1.S2874_CAP Letter for Low Star ratings.pdf | ||
|
H4227 - VISTA HEALTH PLAN, INC. |
Independence Health Group, Inc. | Provider Services | 8005216007 | 38063 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38063_th5f_12092015150211709_1.H4227_CAP Letter for Low Star ratings.pdf |
|
H2241 - GOLDEN STATE MEDICARE HEALTH PLAN |
MacArthur Court Acquisition Corp | 38062 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38062_th5f_12092015140437412_1.H2241_CAP Letter for Low Star ratings.pdf | ||
|
H9122 - ALPHACARE OF NEW YORK, INC. |
Magellan Health, Inc. | 38066 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38066_th5f_12092015152210279_1.H9122_CAP Letter for Low Star ratings.pdf | ||
|
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. |
Molina Healthcare, Inc. | 38070 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38070_th5f_12102015130106237_1.H8130_CAP Letter for Low Star ratings.pdf | ||
|
H5810 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | Member Services | 8006650898 | 38081 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38081_th5f_12102015104700579_1.H5810_CAP Letter for Low Star ratings.pdf |
|
H5985 - PHOENIX HEALTH PLANS, INC. |
Tenet Healthcare Corporation | 38082 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38082_th5f_12102015105402078_1.H5985_CAP Letter for Low Star ratings.pdf | ||
|
H2108 - BRAVO HEALTH MID-ATLANTIC, INC. |
The Cigna Group | Jared Rich | 8006683813 | 38060 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38060_th5f_12092015110142396_1.H2108_CAP Letter for Low Star ratings.pdf |
|
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 38064 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38064_th5f_12092015150742591_1.H4528_CAP Letter for Low Star ratings.pdf | ||
|
H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 38068 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38068_th5f_12102015124809898_1.H6972_CAP Letter for Low Star ratings.pdf | ||
|
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Jared Rich | 8006683813 | 38069 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38069_th5f_12102015125227846_1.H7787_CAP Letter for Low Star ratings.pdf |
|
S5580 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 38050 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38050_th5f_12092015132427790_1.S5580_CAP Letter for Low Star ratings.pdf | ||
|
S5755 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 38061 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38061_th5f_12092015133616340_1.S5755_CAP Letter for Low Star ratings.pdf | ||
|
H4213 - USABLE MUTUAL INSURANCE COMPANY |
USAble Mutual Insurance Company | Customer Service | 8442014934 | 38054 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38054_th5f_12092015144645472_1.H4213_CAP Letter for Low Star ratings.pdf |
|
S8841 - OPTUM INSURANCE OF OHIO, INC. |
UnitedHealth Group, Inc. | Todd Summers | 8664431095 | 38067 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38067_th5f_12102015105911568_1.S8841_CAP Letter for Low Star ratings.pdf |
|
H0712 - WELLCARE OF CONNECTICUT, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38037 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38037_b5ws_12092015090056235_1.H0712_CAP Letter for Low Star ratings.pdf |
|
H1112 - WELLCARE OF GEORGIA, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38038 | 08-DEC-2015 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38038_th5f_12092015103857424_1.H1112_CAP Letter for Low Star ratings.pdf |
|
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | 38039 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38039_th5f_12092015105524317_1.H1903_CAP Letter for Low Star ratings.pdf | ||
|
H3361 - WELLCARE OF NEW YORK, INC. |
WellCare Health Plans, Inc. | 38043 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38043_th5f_12092015123528007_1.H3361_CAP Letter for Low Star ratings.pdf | ||
|
H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38044 | 08-DEC-2015 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38044_th5f_12092015123854867_1.H9730_CAP Letter for Low Star ratings.pdf |
|
S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. |
WellCare Health Plans, Inc. | 38045 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | 38045_th5f_12092015124154832_1.S5967_CAP Letter for Low Star ratings.pdf | ||
|
H5508 - ADVANTAGE HEALTH SOLUTIONS, INC. |
Advantage Health Solutions | 36980 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36980_l4yx_08182015080449381_1.H5508_CAP Letter for Low Star ratings.pdf | ||
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 36968 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36968_l4yx_08182015092415556_1.H5969_CAP Letter for Low Star ratings.pdf |
|
H9285 - ATLANTIS HEALTH PLAN, INC. |
America's 1st Choice NY Holdings, LLC | 36977 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36977_l4yx_08182015095911570_1.H9285_CAP Letter for Low Star ratings.pdf | ||
|
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Caidan Enterprises, Inc. | Provider Services | 8662968731 | 36965 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36965_l4yx_08182015080237541_1.H5475_CAP Letter for Low Star ratings.pdf |
|
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 36908 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36908_l4yx_08172015095425116_1.H0908_CAP Letter for Low Star ratings.pdf |
|
H2323 - FIDELIS SECURECARE OF MICHIGAN |
Centene Corporation | 36912 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36912_l4yx_08172015102106872_1.H2323_CAP Letter for Low Star ratings.pdf | ||
|
H5294 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 36964 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36964_l4yx_08182015075948697_1.H5294_CAP Letter for Low Star ratings.pdf |
|
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. |
Centene Corporation | Provider Services | 8002229831 | 36976 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36976_l4yx_08182015094936616_1.H8189_CAP Letter for Low Star ratings.pdf |
|
H0621 - COLORADO ACCESS |
Colorado Access | 36906 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36906_l4yx_08172015095027600_1.H0621_CAP Letter for Low Star ratings.pdf | ||
|
H4866 - CUATRO LLC |
Cuatro LLC. | 36963 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36963_l4yx_08182015075715421_1.H4866_CAP Letter for Low Star ratings.pdf | ||
|
H2161 - UPPER PENINSULA HEALTH PLAN, LLC |
DLP Marquette General Hospital, LLC | 36911 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36911_l4yx_08172015101828200_1.H2161_CAP Letter for Low Star ratings.pdf | ||
|
H1517 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | 36924 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36924_l4yx_08172015100308946_1.H1517_CAP Letter for Low Star ratings.pdf | ||
|
H7200 - AMERIGROUP TENNESSEE, INC. |
Elevance Health, Inc. | 36972 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36972_l4yx_08182015093336537_1.H7200_CAP Letter for Low Star ratings.pdf | ||
|
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
Elevance Health, Inc. | 36984 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36984_l4yx_08182015083533272_1.H5746_CAP Letter for Low Star ratings.pdf | ||
|
H5528 - EMBLEMHEALTH PLAN, INC. |
EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 36981 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36981_l4yx_08182015080656197_1.H5528_CAP Letter for Low Star ratings.pdf |
|
S0064 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT OF NY |
Express Scripts Holding Company | 37000 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 37000_l4yx_08182015100521299_1.S0064_CAP Letter for Low Star ratings.pdf | ||
|
H5932 - GATEWAY HEALTH PLAN, INC. |
Gateway Health, LLC. | Josh Hartman | 8006855209 | 36966 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36966_l4yx_08182015091836263_1.H5932_CAP Letter for Low Star ratings.pdf |
|
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. |
Health Care Service Corporation | 36971 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36971_l4yx_08182015093105128_1.H6801_CAP Letter for Low Star ratings.pdf | ||
|
S3474 - HEARTLAND FIDELITY INSURANCE COMPANY |
Heartland Fidelity Insurance Company | 37001 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 37001_l4yx_08182015100727241_1.S3474_CAP Letter for Low Star ratings.pdf | ||
|
H5685 - HAP MIDWEST HEALTH PLAN, INC. |
Henry Ford Health System | 36982 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36982_l4yx_08182015080919830_1.H5685_CAP Letter for Low Star ratings.pdf | ||
|
H5887 - MMM HEALTHCARE, LLC. |
InnovaCare Inc. | 36986 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36986_l4yx_08182015084022068_1.H5887_CAP Letter for Low Star ratings.pdf | ||
|
H3337 - LIBERTY HEALTH ADVANTAGE, INC. |
Liberty Health Advantage, Inc. | 36916 * | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36916_l4yx_08172015102831608_1.H3337_CAP Letter for Low Star ratings.pdf | ||
|
H0141 - MCLAREN HEALTH PLAN, INC. |
McLaren Health Care Corporation | 36903 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36903_l4yx_08172015093603899_1.H0141_CAP Letter for Low Star ratings.pdf | ||
|
H0490 - MOLINA HEALTHCARE OF OHIO, INC. |
Molina Healthcare, Inc. | 36904 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36904_l4yx_08172015093952726_1.H0490_CAP Letter for Low Star ratings.pdf | ||
|
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 36973 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36973_l4yx_08182015094211627_1.H7678_CAP Letter for Low Star ratings.pdf |
|
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006651029 | 36985 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36985_l4yx_08182015083809558_1.H5823_CAP Letter for Low Star ratings.pdf |
|
H1659 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
Piedmont Community Health Plan | UHC Customer Service | 8662721967 | 36925 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36925_l4yx_08172015100642126_1.H1659_CAP Letter for Low Star ratings.pdf |
|
H5943 - SCAN HEALTH PLAN |
SCAN Health Plan | Kim McBeath | 8777787226 | 36967 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36967_l4yx_08182015092148226_1.H5943_CAP Letter for Low Star ratings.pdf |
|
H5985 - PHOENIX HEALTH PLANS, INC. |
Tenet Healthcare Corporation | 36969 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36969_l4yx_08182015092632637_1.H5985_CAP Letter for Low Star ratings.pdf | ||
|
H7811 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 36974 * | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36974_l4yx_08182015094431127_1.H7811_CAP Letter for Low Star ratings.pdf | ||
|
S5580 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 37002 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 37002_l4yx_08182015100951405_1.S5580_CAP Letter for Low Star ratings.pdf | ||
|
H3327 - TOUCHSTONE HEALTH HMO, INC. |
Touchstone Health Partnership, Inc | 36915 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36915_l4yx_08172015102625775_1.H3327_CAP Letter for Low Star ratings.pdf | ||
|
H4213 - USABLE MUTUAL INSURANCE COMPANY |
USAble Mutual Insurance Company | Customer Service | 8442014934 | 36962 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36962_l4yx_08182015075409834_1.H4213_CAP Letter for Low Star ratings.pdf |
|
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY |
UnitedHealth Group, Inc. | 36901 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36901_l4yx_08172015093239675_1.H0084_CAP Letter for Low Star ratings.pdf | ||
|
H2111 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 36910 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36910_l4yx_08172015101146287_1.H2111_CAP Letter for Low Star ratings.pdf | ||
|
H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. |
UnitedHealth Group, Inc. | 36913 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36913_l4yx_08172015102342033_1.H2905_CAP Letter for Low Star ratings.pdf | ||
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H3379 - UNITEDHEALTHCARE OF NEW YORK, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8668709604 | 36960 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36960_l4yx_08182015074858823_1.H3379_CAP Letter for Low Star ratings.pdf |
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H3749 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | 36961 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36961_l4yx_08182015075124152_1.H3749_CAP Letter for Low Star ratings.pdf | ||
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H6528 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 36970 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36970_l4yx_08182015092859269_1.H6528_CAP Letter for Low Star ratings.pdf | ||
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H7949 - PACIFICARE OF NEVADA, INC. |
UnitedHealth Group, Inc. | 36975 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36975_l4yx_08182015094650159_1.H7949_CAP Letter for Low Star ratings.pdf | ||
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R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006434845 | 36979 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36979_l4yx_08182015100312830_1.R6801_CAP Letter for Low Star ratings.pdf |
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S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY |
UnitedHealth Group, Inc. | UHC Customer Service | 8664608854 | 37003 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 37003_l4yx_08182015101203166_1.S5921_CAP Letter for Low Star ratings.pdf |
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H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 36921 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36921_l4yx_08172015095758654_1.H0913_CAP Letter for Low Star ratings.pdf |
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H1264 - WELLCARE OF TEXAS, INC. |
WellCare Health Plans, Inc. | 36922 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36922_l4yx_08172015100100586_1.H1264_CAP Letter for Low Star ratings.pdf | ||
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H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | 36926 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36926_l4yx_08172015100920626_1.H1903_CAP Letter for Low Star ratings.pdf | ||
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H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 36978 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36978_l4yx_08182015100114345_1.H9730_CAP Letter for Low Star ratings.pdf |
|
H5698 - HARMONY HEALTH PLAN, INC. |
WellCare Health Plans, Inc. | 36983 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | 36983_l4yx_08182015081136177_1.H5698_CAP Letter for Low Star ratings.pdf | ||
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H2354 - HEALTH ALLIANCE PLAN OF MICHIGAN |
HealthPlus of Michigan | Heather Spencer | 2487763808 | 36201 | 15-JUL-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | 36201_l1h3_07172015090602265_1.ANOC EOC AdHocCap HealthPlus of MI H2354 (2015) REV.pdf |
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H5433 - ORANGE COUNTY HEALTH AUTHORITY |
Orange County Health Authority | Customer Service | 8774122734 | 36202 | 15-JUL-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | 36202_l1h3_07172015085902550_1.ANOC EOC AdHocCap Orange Co Hlth Auth H5433 (2015) REV.pdf |
|
H6743 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 35630 | 29-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35630_n2wm_06032015171451728_1.H6743 - Atrio CAP.pdf |
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H7006 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 35460 | 18-MAY-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | 35460_l1h3_05272015093223649_1.ANOC EOC AdHocCap 2015 Atrio.pdf |
|
H3660 - SUMMACARE INC. |
Summa Health System | Kurt Stahler | 3309968972 | 35461 | 18-MAY-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | 35461_l1h3_05272015093404412_1.ANOC EOC AdHocCap 2015 Summacare.pdf |
|
H3832 - HAWAII MEDICAL SERVICE ASSOCIATION |
Hawaii Medical Service Association | Kevin Unger | 8089486186 | 35635 | 10-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35635_n2wm_06032015173915227_1.H3832 HMSA.pdf |
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H3335 - EXCELLUS HEALTH PLAN, INC. H3351 - EXCELLUS HEALTH PLAN, INC. |
Lifetime Healthcare, Inc. | Brittani Ihle | 7165045556 | 35636 | 10-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35636_n2wm_06032015174111482_1.H3335-H3351 Lifetime Healthcare - Excellus.pdf |
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H4922 - AGEWELL NEW YORK, LLC |
AgeWell New York, LLC | 35633 * | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35633_n2wm_06032015173441485_1.H4922 AgeWell New York.pdf | ||
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H3916 - HIGHMARK SENIOR HEALTH COMPANY H3957 - HIGHMARK CHOICE COMPANY H5106 - HIGHMARK SENIOR SOLUTIONS COMPANY |
Highmark Health | Provider Service | 8665886967 | 35634 | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35634_n2wm_06032015173653325_1.H3916-H3957-H5106 Highmark.pdf |
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H6609 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 35632 | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. NOTE: CAP letter is dated May 5, 2015, and was emailed on May 8, 2015 | 35632_n2wm_06032015172857790_1.H6609-H8145 Humana.pdf |
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H9859 - MVP HEALTH PLAN, INC. |
MVP Health Care, Inc. | 35631 * | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | 35631_n2wm_06032015172518073_1.H9859 MVP Health Plan Inc.pdf | ||
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H3152 - AETNA HEALTH INC. (NJ) H5521 - AETNA LIFE INSURANCE COMPANY H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY |
Aetna Inc. | Aetna Customer Service | 8006240756 | 34380 | 26-FEB-2015 | Drug Benefit | Bid Submission | Failure to comply with CY2015 bid instructions. | 34380_s2k1_02272015110312649_1.CAP Aetna H3152 H5521 H7306 Aetna Feb 26 2015.pdf |
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H0318 - AETNA HEALTH, INC. (PA) H0523 - AETNA HEALTH OF CALIFORNIA INC. H0901 - AETNA HEALTH, INC. (PA) H1013 - COVENTRY HEALTH PLAN OF FLORIDA, INC. H1109 - AETNA HEALTH INC.(GA) H1419 - AETNA HEALTH, INC. (PA) H1608 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H1609 - AETNA HEALTH INC. (FL) H1692 - COVENTRY HEALTH CARE OF WEST VIRGINIA, INC. H2112 - AETNA HEALTH, INC. (PA) H2611 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H2663 - COVENTRY HEALTH CARE OF MISSOURI, INC. H2667 - COVENTRY HEALTH CARE OF MISSOURI, INC H2672 - COVENTRY HEALTH CARE OF KANSAS, INC. H3152 - AETNA HEALTH INC. (NJ) H3312 - AETNA HEALTH INC. (NY) H3597 - AETNA HEALTH INC. (ME) H3623 - AETNA HEALTH, INC. (PA) H3928 - AETNA HEALTH INC. (LA) H3931 - AETNA HEALTH INC. (PA) H3959 - AETNA HEALTH INC. (PA) H4523 - AETNA HEALTH INC. (TX) H4910 - AETNA HEALTH, INC. (PA) H5048 - COVENTRY HEALTH CARE OF TEXAS, INC. H5302 - AETNA HEALTH INC. (GA) H5414 - AETNA HEALTH INC. (FL) H5509 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H5521 - AETNA LIFE INSURANCE COMPANY H5522 - AETNA LIFE INSURANCE COMPANY H5793 - AETNA HEALTH INC. (CT) H5813 - AETNA HEALTH, INC. (PA) H5832 - AETNA HEALTH, INC. (PA) H6560 - COVENTRY HEALTH CARE OF VIRGINIA, INC. H6923 - AETNA HEALTH, INC. (PA) H7149 - AETNA HEALTH INC. (PA) H7301 - COVENTRY HEALTH CARE OF ILLINOIS, INC. H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY H7908 - AETNA HEALTH, INC. (PA) H8393 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H8649 - AETNA HEALTH OF UTAH INC. H8980 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H9847 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY S5569 - CAMBRIDGE LIFE INSURANCE COMPANY S5674 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY S5768 - WELLCARE PRESCRIPTION INSURANCE, INC. S5810 - WELLCARE PRESCRIPTION INSURANCE, INC. |
Aetna Inc. | Aetna Customer Service | 8006240756, 8335706670 | 34139 | 28-JAN-2015 | Drug Benefit | Access to Services--Pharmacies/Prescription Drug | Failure to adhere to Any Willing Pharmacy requirements, which resulted in substantial access issues at point of sale when beneficiaries, pharmacies, Aetna, and CMS were unclear on which pharmacies were included in the 2015 network. | 34139_s2k1_01302015222825733_1.AETNA CAP 01302015.pdf |
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H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 33575 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | 33575_d4z8_12102014145837339_1.AlohaCare ANOC EOC CAP 12092014.pdf |
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H9302 - PREMERA BLUE CROSS |
Catholic Health Initiatives | 33594 * | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | 33594_d4z8_12122014115651774_1.CatholicHealthInitiatives ANOC EOC CAP 120914.pdf | ||
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H5932 - GATEWAY HEALTH PLAN, INC. |
Gateway Health, LLC. | Josh Hartman | 8006855209 | 33612 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | 33612_d4z8_12152014103814461_1.Gateway Health Plan ANOC EOC CAP 120914.pdf |
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H5050 - KAISER FOUNDATION HEALTH PLAN OF WASHINGTON |
Group Health Cooperative | Provider Assistance Unit | 8887674670 | 33613 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | 33613_d4z8_12152014104348624_1.Group Health Cooperative ANOC EOC CAP 120914.pdf |
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H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 33634 * | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | 33634_d4z8_12152014111709685_1.MolinaHealthCare ANOC EOC CAP 120914.pdf | ||
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H7149 - AETNA HEALTH INC. (PA) |
Aetna Inc. | Aetna Customer Service | 8335706670 | 32633 | 07-AUG-2014 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2014 INACCURATE ANNUAL NOTICE OF CHANGE/EVIDENCE OF COVERAGE (ANOC/EOC) | 32633_gv5j_08072014101148765_1.Aetna ANOC EOC Ad Hoc Cap 080714.pdf |
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H1444 - TOTAL HEALTH CARE, INC. |
Total Health Care, Inc. | 32634 * | 07-AUG-2014 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2014 INACCURATE ANNUAL NOTICE OF CHANGE/EVIDENCE OF COVERAGE (ANOC/EOC) | 32634_gv5j_08072014101325939_1.Total Health Care ANOC EOC Ad Hoc Cap 080714.pdf | ||
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H8393 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY |
Aetna Inc. | 32019 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | 32019_l1h3_06042014100856609_1.Aetna ANOC EOC Ad Hoc Cap 053014.pdf | ||
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H2810 - GROUP HEALTH OPTIONS |
Group Health Cooperative | 32020 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | 32020_l1h3_06042014101947995_1.Group Hlth Coop ANOC EOC Ad Hoc Cap 053014.pdf | ||
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R5826 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 32052 | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | 32052_l1h3_06042014102435928_1.Humana ANOC EOC Ad Hoc Cap 053014.pdf |
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H4123 - MERCYCARE HMO, INC. |
Mercy Alliance, Inc. | 32021 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials\n | 32021_l1h3_06042014103946824_1.Mercy Alliance ANOC EOC Ad Hoc Cap 053014.pdf | ||
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H3907 - UPMC HEALTH PLAN, INC. H4279 - UPMC FOR YOU, INC H5533 - UPMC HEALTH NETWORK, INC. H9670 - UPMC HEALTH BENEFITS, INC. |
UPMC Health System | Medicare Marketing | 8773813765 | 31912 | 28-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 31912_n2wm_05292014145837320_1.OACT CAP - UPMC - 2014.pdf |
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H3923 - CAPITAL ADVANTAGE INSURANCE COMPANY H3962 - KEYSTONE HEALTH PLAN CENTRAL, INC. |
CAPITAL BLUE CROSS | Gloria Yu | 8666882242 | 31774 | 21-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 31774_n2wm_05212014163803139_1.OACT CAP - Capital BlueCross - 2014.pdf |
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S8067 - Avalon Insurance Company |
CAPITAL BLUE CROSS | Gloria Yu | 8666882242 | 34721 | 21-MAY-2014 | Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 34721_s2k1_03182015220653626_1.31774_n2wm_05212014163803139_1.OACT CAP - Capital BlueCross - 2014.pdf |
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H0028 - CHA HMO, INC. H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0248 - HUMANA INSURANCE COMPANY H0317 - HUMANA INSURANCE COMPANY H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1291 - HUMANA INSURANCE COMPANY OF NEW YORK H1406 - HUMANA HEALTH PLAN, INC. H1418 - HUMANA INSURANCE COMPANY H1468 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H1510 - HUMANA INSURANCE COMPANY H1681 - HUMANA INSURANCE COMPANY H1716 - HUMANA INSURANCE COMPANY H1906 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2486 - HUMANA MEDICAL PLAN OF UTAH, INC. H2542 - HUMANA INSURANCE COMPANY H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H3405 - HUMANA INSURANCE COMPANY H3533 - HUMANA HEALTH COMPANY OF NEW YORK, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4145 - HUMANA REGIONAL HEALTH PLAN, INC. H4408 - HUMANA INSURANCE COMPANY H4461 - CARITEN HEALTH PLAN INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H4520 - HUMANA INSURANCE COMPANY H4606 - HUMANA INSURANCE COMPANY H4956 - HUMANA INSURANCE COMPANY H5041 - HUMANA INSURANCE COMPANY H5214 - HUMANA INSURANCE COMPANY H5216 - HUMANA INSURANCE COMPANY H5291 - HUMANA HEALTH PLAN, INC. H5415 - HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. H5416 - ARCADIAN HEALTH PLAN, INC. H5525 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H5619 - ARCADIAN HEALTH PLAN, INC. H5868 - HUMANA INSURANCE COMPANY H5970 - HUMANA INSURANCE COMPANY OF NEW YORK H6411 - HUMANA INSURANCE COMPANY H6609 - HUMANA INSURANCE COMPANY H6622 - HUMANA WI HEALTH ORGANIZATION INSURANCE CORP H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. H7002 - HUMANA INSURANCE COMPANY H7188 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY H8644 - HUMANA INSURANCE COMPANY H8707 - HUMANA INSURANCE COMPANY H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. H8953 - HUMANA HEALTH PLAN OF OHIO, INC. H9503 - HUMANA INSURANCE COMPANY R5826 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 31773 | 21-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 31773_n2wm_05212014163603439_1.OACT CAP - HUMANA - 2014.pdf |
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S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. S5552 - HUMANA INSURANCE COMPANY OF NEW YORK S5884 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 34699 | 21-MAY-2014 | Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 34699_s2k1_03182015140800659_1.31773_n2wm_05212014163603439_1.OACT CAP - HUMANA - 2014.pdf |
|
H0901 - AETNA HEALTH, INC. (PA) |
Aetna Inc. | 31537 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31537_04212014100656679.Low Star Rating CAP_H0901.pdf | ||
|
H1109 - AETNA HEALTH INC.(GA) |
Aetna Inc. | Aetna Customer Service | 8006240756 | 31541 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31541_04212014100656679.Low Star Rating CAP_H1109.pdf |
|
H4523 - AETNA HEALTH INC. (TX) |
Aetna Inc. | Aetna Customer Service | 8006240756 | 31572 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31572_04212014100656679.Low Star Rating CAP_H4523.pdf |
|
H0979 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. |
America's 1st Choice Holdings of N.C., LLC | 31539 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31539_04212014100656679.Low Star Rating CAP_H0979.pdf | ||
|
H4268 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. |
America's 1st Choice Holdings of N.C., LLC | 31570 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31570_04212014100656679.Low Star Rating CAP_H4268.pdf | ||
|
H3421 - AMERICA'S 1ST CHOICE HEALTH PLANS, INC. |
America's 1st Choice Holdings of S.C., LLC | 31557 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31557_04212014100656679.Low Star Rating CAP_H3421.pdf | ||
|
H4738 - AMERICA'S 1ST CHOICE HEALTH PLANS, INC. |
America's 1st Choice Holdings of S.C., LLC | 31573 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31573_04212014100656679.Low Star Rating CAP_H4738.pdf | ||
|
S1480 - AULTCARE INSURANCE COMPANY |
Aultman Health Foundation | 31612 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31612_04212014100656679.Low Star Rating CAP_S1480.pdf | ||
|
H4209 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA |
BlueCross BlueShield of South Carolina (BCBSSC) | 31569 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31569_04212014100656679.Low Star Rating CAP_H4209.pdf | ||
|
S5601 - SILVERSCRIPT INSURANCE COMPANY |
CVS Health Corporation | Kelly Devine | 8662355660 | 31614 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31614_04212014100656679.Low Star Rating CAP_S5601.pdf |
|
H5430 - ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC. |
Care1st Health Plan | 31581 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31581_04212014100656679.Low Star Rating CAP_H5430.pdf | ||
|
H6178 - CARESOURCE |
CareSource | 31598 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31598_04212014100656679.Low Star Rating CAP_H6178 (2).pdf | ||
|
H6178 - CARESOURCE |
CareSource | 31599 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31599_04212014100656679.Low Star Rating CAP_H6178.pdf | ||
|
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 31538 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31538_04212014100656679.Low Star Rating CAP_H0908.pdf |
|
H5294 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 31577 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31577_04212014100656679.Low Star Rating CAP_H5294.pdf |
|
H5590 - Bridgeway Health Solutions of Arizona, Inc. |
Centene Corporation | Provider Services | 8773915921 | 31587 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31587_04212014100656679.Low Star Rating CAP_H5590.pdf |
|
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. |
Centene Corporation | Provider Services | 8002229831 | 31605 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31605_04212014100656679.Low Star Rating CAP_H8189.pdf |
|
H4866 - CUATRO LLC |
Cuatro LLC. | 31575 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31575_04212014100656679.Low Star Rating CAP_H4866.pdf | ||
|
H5608 - DENVER HEALTH MEDICAL PLAN, INC. |
Denver Health and Hospital Authority | HealthPlan Services | 3036022111 | 31588 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31588_04212014100656679.Low Star Rating CAP_H5608.pdf |
|
H3347 - ELDERPLAN, INC. |
Elderplan, Inc. | Doretha Alston | 7189217979 | 31555 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31555_04212014100656679.Low Star Rating CAP_H3347 (2).pdf |
|
H3347 - ELDERPLAN, INC. |
Elderplan, Inc. | Doretha Alston | 7189217979 | 31556 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31556_04212014100656679.Low Star Rating CAP_H3347.pdf |
|
H3240 - WELLPOINT NEW JERSEY, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 31552 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31552_04212014100656679.Low Star Rating CAP_H3240 (2).pdf |
|
H3240 - WELLPOINT NEW JERSEY, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 31553 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31553_04212014100656679.Low Star Rating CAP_H3240.pdf |
|
H5896 - AMERIGROUP MARYLAND, INC. |
Elevance Health, Inc. | Dedicated Services Unit | 8668054589 | 31596 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31596_04212014100656679.Low Star Rating CAP_H5896.pdf |
|
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. |
Elevance Health, Inc. | 31607 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31607_04212014100656679.Low Star Rating CAP_H9947.pdf | ||
|
S5960 - WELLPOINT LIFE AND HEALTH INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 31620 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31620_04212014100656679.Low Star Rating CAP_S5960.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Envision Topco Holdings, LLC | 31621 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31621_04212014100656679.Low Star Rating CAP_S7694.pdf | ||
|
H3818 - FAMILYCARE HEALTH PLANS, INC. |
FamilyCare Incorporated | 31558 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31558_04212014100656679.Low Star Rating CAP_H3818.pdf | ||
|
H4011 - MMM HEALTHCARE, LLC |
First Medical Health Plan, Inc. | 31565 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31565_04212014100656679.Low Star Rating CAP_H4011.pdf | ||
|
H5887 - MMM HEALTHCARE, LLC. |
First Medical Health Plan, Inc. | 31594 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31594_04212014100656679.Low Star Rating CAP_H5887 (2).pdf | ||
|
H5887 - MMM HEALTHCARE, LLC. |
First Medical Health Plan, Inc. | 31595 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31595_04212014100656679.Low Star Rating CAP_H5887.pdf | ||
|
S5840 - FIRST MEDICAL HEALTH PLAN, INC. |
First Medical Health Plan, Inc. | 31617 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31617_04212014100656679.Low Star Rating CAP_S5840.pdf | ||
|
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. |
Health Care Service Corporation | 31600 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31600_04212014100656679.Low Star Rating CAP_H6801.pdf | ||
|
H5439 - HEALTH NET LIFE INSURANCE COMPANY |
Health Net, Inc. | Provider Services | 8002754737 | 31582 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31582_04212014100656679.Low Star Rating CAP_H5439.pdf |
|
H1681 - HUMANA INSURANCE COMPANY |
Humana Inc. | 31546 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31546_04212014100656679.Low Star Rating CAP_H1681.pdf | ||
|
H5416 - ARCADIAN HEALTH PLAN, INC. |
Humana Inc. | 31580 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31580_04212014100656679.Low Star Rating CAP_H5416.pdf | ||
|
H7188 - HUMANA INSURANCE COMPANY |
Humana Inc. | 31602 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31602_04212014100656679.Low Star Rating CAP_H7188.pdf | ||
|
H5640 - IEHP HEALTH ACCESS |
INLAND EMPIRE HEALTH PLAN | 31589 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31589_04212014100656679.Low Star Rating CAP_H5640.pdf | ||
|
S2321 - QCC INSURANCE COMPANY |
Independence Blue Cross | 31613 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31613_04212014100656679.Low Star Rating CAP_S2321.pdf | ||
|
H4003 - MMM HEALTHCARE, LLC |
InnovaCare Inc. | Janice Quinones | 8666766060 | 31561 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31561_04212014100656679.Low Star Rating CAP_H4003.pdf |
|
H4004 - MMM HEALTHCARE, LLC |
InnovaCare Inc. | Janice Quinones | 8666766060 | 31562 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31562_04212014100656679.Low Star Rating CAP_H4004.pdf |
|
H2643 - LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY |
Local Initiative Health Authority for LA County | 31549 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31549_04212014100656679.Low Star Rating CAP_H2643.pdf | ||
|
H4006 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | 31564 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31564_04212014100656679.Low Star Rating CAP_H4006.pdf | ||
|
H5580 - MERCY CARE |
Mercy Care | Shannon Richardson | 6024535592 | 31585 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31585_04212014100656679.Low Star Rating CAP_H5580.pdf |
|
H5471 - SIMPLY HEALTHCARE PLANS, INC. |
Simply Healthcare Holdings, Inc. | Customer Service | 8882307338 | 31583 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31583_04212014100656679.Low Star Rating CAP_H5471.pdf |
|
H5587 - HEALTH CHOICE ARIZONA, INC. |
Steward Health Care System, LLC | Member Services | 8006568991 | 31586 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31586_04212014100656679.Low Star Rating CAP_H5587.pdf |
|
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 31567 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31567_04212014100656679.Low Star Rating CAP_H4125.pdf | ||
|
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 31568 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31568_04212014100656679.Low Star Rating CAP_H4125 (2).pdf | ||
|
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Jared Rich | 8006683813 | 31603 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31603_04212014100656679.Low Star Rating CAP_H7787.pdf |
|
S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 31619 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31619_04212014100656679.Low Star Rating CAP_S5932.pdf | ||
|
S5755 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 31615 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31615_04212014100656679.Low Star Rating CAP_S5755.pdf | ||
|
H3327 - TOUCHSTONE HEALTH HMO, INC. |
Touchstone Health Partnership, Inc | 31554 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31554_04212014100656679.Low Star Rating CAP_H3327.pdf | ||
|
H4005 - TRIPLE S ADVANTAGE, INC. |
Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 31563 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31563_04212014100656679.Low Star Rating CAP_H4005.pdf |
|
H4012 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 31566 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31566_04212014100656679.Low Star Rating CAP_H4012.pdf | ||
|
H5732 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 31592 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31592_04212014100656679.Low Star Rating CAP_H5732.pdf | ||
|
H5732 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 31593 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31593_04212014100656679.Low Star Rating CAP_H5732 (2).pdf | ||
|
S5775 - TRIPLE S SALUD, INC. |
Triple-S Management Corporation | 31616 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31616_04212014100656679.Low Star Rating CAP_S5775.pdf | ||
|
S5907 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 31618 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31618_04212014100656679.Low Star Rating CAP_S5907.pdf | ||
|
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY |
UnitedHealth Group, Inc. | 31532 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31532_04212014100656679.Low Star Rating CAP_H0084.pdf | ||
|
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006901606 | 31533 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31533_04212014100656679.Low Star Rating CAP_H0251.pdf |
|
H0624 - UnitedHealthcare Benefits of Texas, Inc. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 31535 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31535_04212014100656679.Low Star Rating CAP_H0624.pdf |
|
H1108 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 31540 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31540_04212014100656679.Low Star Rating CAP_H1108.pdf | ||
|
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 31542 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31542_04212014100656679.Low Star Rating CAP_H1111.pdf | ||
|
H1717 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 31547 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31547_04212014100656679.Low Star Rating CAP_H1717.pdf | ||
|
H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. |
UnitedHealth Group, Inc. | 31550 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31550_04212014100656679.Low Star Rating CAP_H2905.pdf | ||
|
H3209 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 31551 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31551_04212014100656679.Low Star Rating CAP_H3209.pdf | ||
|
H3887 - UNITEDHEALTHCARE OF THE MIDWEST, INC. |
UnitedHealth Group, Inc. | 31559 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31559_04212014100656679.Low Star Rating CAP_H3887.pdf | ||
|
H3921 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 31560 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31560_04212014100656679.Low Star Rating CAP_H3921.pdf | ||
|
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | 31571 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31571_04212014100656679.Low Star Rating CAP_H4406.pdf | ||
|
H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | 31574 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31574_04212014100656679.Low Star Rating CAP_H4837.pdf | ||
|
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC |
UnitedHealth Group, Inc. | 31601 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31601_04212014100656679.Low Star Rating CAP_H6952.pdf | ||
|
H7949 - PACIFICARE OF NEVADA, INC. |
UnitedHealth Group, Inc. | 31604 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31604_04212014100656679.Low Star Rating CAP_H7949.pdf | ||
|
H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. |
UnitedHealth Group, Inc. | 31606 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31606_04212014100656679.Low Star Rating CAP_H9011.pdf | ||
|
R3444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8773703207 | 31608 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31608_04212014100656679.Low Star Rating CAP_R3444.pdf |
|
R3444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8773703207 | 31609 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31609_04212014100656679.Low Star Rating CAP_R3444 (2).pdf |
|
R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006434845 | 31610 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31610_04212014100656679.Low Star Rating CAP_R6801.pdf |
|
R9896 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 31611 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31611_04212014100656679.Low Star Rating CAP_R9896.pdf | ||
|
H5378 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 31578 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31578_04212014100656679.Low Star Rating CAP_H5378 (2).pdf | ||
|
H5378 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 31579 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31579_04212014100656679.Low Star Rating CAP_H5378.pdf | ||
|
H6169 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 31597 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31597_04212014100656679.Low Star Rating CAP_H6169.pdf | ||
|
H0838 - UNIVERSAL CARE, INC. |
Universal Care, Inc | 31536 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31536_04212014100656679.Low Star Rating CAP_H0838.pdf | ||
|
H5549 - VNS CHOICE |
Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 31584 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31584_04212014100656679.Low Star Rating CAP_H5549.pdf |
|
H0320 - WELLCARE OF TEXAS, INC. |
WellCare Health Plans, Inc. | 31534 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31534_04212014100656679.Low Star Rating CAP_H0320.pdf | ||
|
H1112 - WELLCARE OF GEORGIA, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 31543 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31543_04212014100656679.Low Star Rating CAP_H1112.pdf |
|
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. |
WellCare Health Plans, Inc. | 31544 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31544_04212014100656679.Low Star Rating CAP_H1216.pdf | ||
|
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. |
WellCare Health Plans, Inc. | 31545 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31545_04212014100656679.Low Star Rating CAP_H1216 (2).pdf | ||
|
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | 31548 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31548_04212014100656679.Low Star Rating CAP_H1903.pdf | ||
|
H5087 - WELLCARE OF CALIFORNIA, INC. |
WellCare Health Plans, Inc. | Provider Services | 8662968731 | 31576 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31576_04212014100656679.Low Star Rating CAP_H5087.pdf |
|
H5698 - HARMONY HEALTH PLAN, INC. |
WellCare Health Plans, Inc. | 31590 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31590_04212014100656679.Low Star Rating CAP_H5698.pdf | ||
|
H5698 - HARMONY HEALTH PLAN, INC. |
WellCare Health Plans, Inc. | 31591 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | 31591_04212014100656679.Low Star Rating CAP_H5698 (2).pdf | ||
|
H0117 - WELLCARE OF OHIO, INC. H0320 - WELLCARE OF TEXAS, INC. H0712 - WELLCARE OF CONNECTICUT, INC. H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. H1032 - Sunshine State Health Plan, Inc. H1112 - WELLCARE OF GEORGIA, INC. H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. H1264 - WELLCARE OF TEXAS, INC. H1416 - HARMONY HEALTH PLAN, INC. H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H3361 - WELLCARE OF NEW YORK, INC. H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 30830 | 27-FEB-2014 | Drug Benefit | Plan Finder Data | Sponsor contracts listed abovefailured to comply with Part D requirements concerning the representation of its contracted pharmacy network in its marketing materials and in reports to CMS for use in populating the Medicare Plan Finder (MPF). | 30830_l4yx_02282014131413595_1.WellCarePartDPharmacyCAP022714.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Envision Pharmaceutical Holdings, Inc. | 31027 | 31-DEC-2013 | Drug Benefit | Formulary Submission and Administration | Failure to appropriately implement a fomlary transition policy. Failed to meet the threshold for both CY2012 and CY2013 | 31027_i24q_03052014141725641_1.S7694_Envision_TMPA CAP TM.pdf | ||
|
H5587 - HEALTH CHOICE ARIZONA, INC. |
Steward Health Care System, LLC | Member Services | 8006568991 | 30572 | 31-DEC-2013 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 30572_m5nx_02112014155206605_1.4RxCAP_Letter_H5587.pdf |
|
S5755 - SILVERSCRIPT INSURANCE COMPANY |
Torchmark Corporation | 30571 * | 31-DEC-2013 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 30571_m5nx_02112014154805270_1.4RxCAP_Letter_S5755.pdf | ||
|
S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. |
WellCare Health Plans, Inc. | 31028 * | 31-DEC-2013 | Drug Benefit | Formulary Submission and Administration | Failure to appropriately implement a fomlary transition policy. Failed to meet the threshold for both CY2012 and CY2013 | 31028_i24q_03052014141814485_1.S5967_WellCare_TMPA_CAP TM.pdf | ||
|
H4005 - TRIPLE S ADVANTAGE, INC. H4012 - TRIPLE-S SALUD, INC. H5732 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 30282 | 26-DEC-2013 | Health Benefit | Other | Triple S failed to comply with Part C requirements related to the credentialing and re-credentialing of contracted providers. | 30282_f2rw_01142014090805871_1.TRIPLE S CRED CAP12262013.pdf |
|
H5928 - California Physicians' Service |
Care1st Health Plan | Member Services | 8007764466 | 28822 | 30-AUG-2013 | Drug Benefit | Plan Corrections | Care1st received this CAP for requesting and needing to implement signficant changes in the Plan Corrections arena. | 28822_n2wm_09032013121321152_1.Care1st - CAP FINAL Email Ready.pdf |
|
H9003 - KAISER FOUNDATION HP OF THE N W |
Kaiser Foundation Health Plan, Inc. | Member Services | 8772218221 | 27789 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | 27789_d3w0_07082013153129170_1.Kaiser_ANOC_EOC_CAP.pdf |
|
H5577 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | Deliannie Gonzalez | 7877582500 | 27786 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | 27786_d3w0_07082013152345301_1.Med Card System_ANOC_EOC_CAP.pdf |
|
H3810 - ALLCARE HEALTH PLAN, INC. |
MidRogue AllCare Health Assurance, Inc. | Nicole LaFond | 8884600185 | 27783 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | 27783_d3w0_07082013151453338_1.Mid Rogue CHP_ANOC_EOC_CAP.pdf |
|
H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0317 - HUMANA INSURANCE COMPANY H0623 - HUMANA INSURANCE COMPANY H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1406 - HUMANA HEALTH PLAN, INC. H1716 - HUMANA INSURANCE COMPANY H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H4606 - HUMANA INSURANCE COMPANY H5291 - HUMANA HEALTH PLAN, INC. H5416 - ARCADIAN HEALTH PLAN, INC. H5426 - HUMANA ADVANTAGECARE PLAN, INC. H5868 - HUMANA INSURANCE COMPANY H6609 - HUMANA INSURANCE COMPANY H7188 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY H8644 - HUMANA INSURANCE COMPANY R5826 - HUMANA INSURANCE COMPANY S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 27202 | 06-MAY-2013 | Health and Drug Benefit | Bid Submission | Humana recieved this CAP due to various actuarial compliance issues regarding their bid submission. | 27202_n2wm_05092013114147668_1.Humana OACT CAP FINAL EMAIL READY.pdf |
|
H0117 - WELLCARE OF OHIO, INC. H0320 - WELLCARE OF TEXAS, INC. H0712 - WELLCARE OF CONNECTICUT, INC. H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. H1112 - WELLCARE OF GEORGIA, INC. H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. H1264 - WELLCARE OF TEXAS, INC. H1416 - HARMONY HEALTH PLAN, INC. H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H3361 - WELLCARE OF NEW YORK, INC. S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 27542 | 24-APR-2013 | Health and Drug Benefit | Access to Services--Pharmacies/Prescription Drug, Call Center Requirements | WellCare failed to meet its internal performance standards regarding access to mail order pharmacy. In addition WellCare failed to meet CMS' call center requirements. CMS is requesting a corrective action plan to address the identified instances of non-compliance. | 27542_gdw2_06272013113217478_1.NONC-CAP Request_call center and mail order.pdf |
|
S0064 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT OF NY |
RCGM, LLC | 26182 * | 26-FEB-2013 | Drug Benefit | Call Center Requirements, Oversight and Management Capabilities | Corrective Action Plan request for failure to operate a customer service call center that provides customer telephone service as well as failing to exercise oversight and control of the call center. This request is a result of the organization not having an operational toll-free customer service telephone number at the beginning of the year and its management’s lack of awareness of this as and the resulting complaints from beneficiaries. | 26182_v2i9_05012013145231071_1.b5ws_02262013134833834_1.SmartD_Rx_CAP_Request_Call_Center_2013_.pdf | ||
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H0544 - BLUE CROSS OF CALIFORNIA |
Elevance Health, Inc. | Customer Service | 8882307338 | 25410 | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 25410_v2i9_02072013125628450_1.m5nx_01092013111623297_1.2013 4RxCAP H0544.pdf |
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S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25408 * | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 25408_v2i9_02072013103315258_1.m5nx_01092013111232945_1.2013 4RxCAP S5932.pdf | ||
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H7281 - BRAVO HEALTH PENNSYLVANIA, INC. |
The Cigna Group | 25409 * | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 25409_v2i9_02072013123750672_1.m5nx_01092013111359011_1.2013 4RxCAP H7281.pdf | ||
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S5904 - BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. |
Blue Cross and Blue Shield of Florida | Medicare Mbr Svcs | 8009266565 | 24954 | 19-DEC-2012 | Drug Benefit | Bid Submission | Actuarial deficiencies regarding bid submission. | 24954_v2i9_02072013130326959_1.n2wm_12192012103146806_1.BCBS Florida OACT Letter - Final Version- Email Ready.pdf |
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H3240 - WELLPOINT NEW JERSEY, INC. |
AMERIGROUP Corporation | Customer Service | 8882307338 | 25004 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25004_v2i9_02072013130913051_1.25004_12192012135612823.LT32013_H3240C.pdf |
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H3240 - WELLPOINT NEW JERSEY, INC. |
AMERIGROUP Corporation | Customer Service | 8882307338 | 25005 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25005_v2i9_02072013131824584_1.25005_12192012135612823.LT32013_H3240.pdf |
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H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. |
AMERIGROUP Corporation | 25084 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25084_v2i9_02072013133217516_1.25084_12192012135612823.LT32013_H5746.pdf | ||
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H5817 - AMERIGROUP TEXAS, INC. |
AMERIGROUP Corporation | 25088 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25088_v2i9_02072013163206179_1.25088_12192012135612823.LT32013_H5817.pdf | ||
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H5896 - AMERIGROUP MARYLAND, INC. |
AMERIGROUP Corporation | Dedicated Services Unit | 8668054589 | 25090 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25090_v2i9_02072013163817571_1.25090_12192012135612823.LT32013_H5896.pdf |
|
H6181 - AMERIGROUP NEW YORK, LLC |
AMERIGROUP Corporation | 25092 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25092_v2i9_02072013164343276_1.25092_12192012135612823.LT32013_H6181.pdf | ||
|
H7200 - AMERIGROUP TENNESSEE, INC. |
AMERIGROUP Corporation | 25095 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25095_v2i9_02072013164714149_1.25095_12192012135612823.LT32013_H7200.pdf | ||
|
H8991 - AMERIGROUP FLORIDA, INC. |
AMERIGROUP Corporation | 25100 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25100_v2i9_02072013165008281_1.25100_12192012135612823.LT32013_H8991.pdf | ||
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H8822 - ADVANTAGE HEALTH SOLUTIONS, INC. |
Advantage Health Solutions | 24992 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24992_v2i9_02082013103155817_1.24992_12192012135612823.LT3_2013_H8822.pdf | ||
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 24978 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24978_v2i9_02082013103614470_1.24978_12192012135612823.LT3_2013_H5969.pdf |
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H4268 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. |
America's 1st Choice Holdings of N.C., LLC | 24988 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24988_v2i9_02082013105236241_1.24988_12192012135612823.LT3_2013_H4268.pdf | ||
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S0043 - PREFERRED MEDICARE CHOICE, INC. |
Aveta Inc. | 25104 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25104_v2i9_02082013105530456_1.25104_12192012135612823.LT32013_S0043.pdf | ||
|
S5937 - LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY |
BlueCross BlueShield of Louisiana | 25111 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25111_v2i9_02082013110340109_1.25111_12192012135612823.LT32013_S5937.pdf | ||
|
H4209 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA |
BlueCross BlueShield of South Carolina (BCBSSC) | 25067 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25067_v2i9_02092013155842203_1.25067_12192012135612823.LT32013_H4209.pdf | ||
|
S5953 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA |
BlueCross BlueShield of South Carolina (BCBSSC) | Provider Services | 8003342583 | 25112 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25112_v2i9_02092013160900116_1.25112_12192012135612823.LT32013_S5953.pdf |
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H5884 - BLUECROSS BLUESHIELD OF TENNESSEE |
BlueCross BlueShield of Tennessee | Carol Troxell | 8008417434 | 24990 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24990_v2i9_02092013164105161_1.24990_12192012135612823.LT3_2013_H5884.pdf |
|
H6178 - CARESOURCE |
CareSource | 25091 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25091_v2i9_02102013155126153_1.25091_12192012135612823.LT32013_H6178.pdf | ||
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H5590 - Bridgeway Health Solutions of Arizona, Inc. |
Centene Corporation | Provider Services | 8773915921 | 25041 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25041_v2i9_02102013160124608_1.25041_12192012135612823.LT32013_H5590.pdf |
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H5294 - SUPERIOR HEALTHPLAN, INC. |
Centene Corporation | Member Services | 8779358023 | 25072 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25072_v2i9_02102013160647954_1.25072_12192012135612823.LT32013_H5294.pdf |
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H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. |
Central Health Plan of California | Marketing Department | 6263882390 | 25042 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25042_v2i9_02102013161216759_1.25042_12192012135612823.LT32013_H5649.pdf |
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H0621 - COLORADO ACCESS |
Colorado Access | 24964 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24964_v2i9_02102013161707640_1.24964_12192012135612823.LT3_2013_H0621.pdf | ||
|
S5857 - PRIORITY HEALTH INSURANCE COMPANY |
Corewell Health | Customer Service | 8883896648 | 24981 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24981_h5dv_02072013140101474_1.24981_12192012135612823.LT3_2013_S5857.pdf |
|
H2611 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY |
Coventry Health Care Inc. | 25061 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25061_v2i9_02102013163315680_1.25061_12192012135612823.LT32013_H2611.pdf | ||
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H5302 - AETNA HEALTH INC. (GA) |
Coventry Health Care Inc. | Aetna Customer Service | 8006240756 | 25073 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25073_v2i9_02102013164109465_1.25073_12192012135612823.LT32013_H5302.pdf |
|
H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY |
Coventry Health Care Inc. | 25096 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25096_v2i9_02102013165659434_1.25096_12192012135612823.LT32013_H7306.pdf | ||
|
H5608 - DENVER HEALTH MEDICAL PLAN, INC. |
Denver Health and Hospital Authority | HealthPlan Services | 3036022111 | 24974 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24974_v2i9_02102013170058758_1.24974_12192012135612823.LT3_2013_H5608.pdf |
|
H3347 - ELDERPLAN, INC. |
Elderplan, Inc. | Doretha Alston | 7189217979 | 24970 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24970_v2i9_02102013170557174_1.24970_12192012135612823.LT3_2013_H3347.pdf |
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H1607 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 25055 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25055_p44x_02072013135552010_1.25055_12192012135612823.LT32013_H1607.pdf |
|
H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. |
Elevance Health, Inc. | 25057 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25057_p44x_02072013135944861_1.25057_12192012135612823.LT32013_H1849.pdf | ||
|
H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. |
Elevance Health, Inc. | 25077 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25077_p44x_02072013140256697_1.25077_12192012135612823.LT32013_H5530.pdf | ||
|
S5960 - WELLPOINT LIFE AND HEALTH INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 25113 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25113_p44x_02072013140640265_1.25113_12192012135612823.LT32013_S5960.pdf |
|
H4011 - MMM HEALTHCARE, LLC |
First Medical Health Plan, Inc. | 25010 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25010_v2i9_02102013173138302_1.25010_12192012135612823.LT32013_H4011C.pdf | ||
|
H4011 - MMM HEALTHCARE, LLC |
First Medical Health Plan, Inc. | 25011 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25011_v2i9_02102013175322916_1.25011_12192012135612823.LT32013_H4011.pdf | ||
|
H5887 - MMM HEALTHCARE, LLC. |
First Medical Health Plan, Inc. | 25026 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25026_v2i9_02102013180539401_1.25026_12192012135612823.LT32013_H5887C.pdf | ||
|
H5887 - MMM HEALTHCARE, LLC. |
First Medical Health Plan, Inc. | 25027 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25027_v2i9_02102013181014417_1.25027_12192012135612823.LT32013_H5887.pdf | ||
|
S5840 - FIRST MEDICAL HEALTH PLAN, INC. |
First Medical Health Plan, Inc. | 25108 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25108_v2i9_02102013185749956_1.25108_12192012135612823.LT32013_S5840.pdf | ||
|
H7015 - HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. |
HF Management Services, LLC | 25044 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25044_v2i9_02112013062127799_1.25044_12192012135612823.LT32013_H7015.pdf | ||
|
H5685 - HAP MIDWEST HEALTH PLAN, INC. |
Henry Ford Health System | 25081 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25081_v2i9_02112013062505636_1.25081_12192012135612823.LT32013_H5685.pdf | ||
|
H5416 - ARCADIAN HEALTH PLAN, INC. |
Humana Inc. | 24973 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24973_v2i9_02112013062740145_1.24973_12192012135612823.LT3_2013_H5416.pdf | ||
|
H0320 - WELLCARE OF TEXAS, INC. |
Humana Inc. | 24982 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24982_v2i9_02112013062953274_1.24982_12192012135612823.LT3_2013_H0320.pdf | ||
|
H5041 - HUMANA INSURANCE COMPANY |
Humana Inc. | 24989 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24989_v2i9_02112013063259112_1.24989_12192012135612823.LT3_2013_H5041.pdf | ||
|
H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 24998 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24998_v2i9_02112013063521172_1.24998_12192012135612823.LT32013_H2029C.pdf |
|
H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 24999 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24999_v2i9_02112013063742356_1.24999_12192012135612823.LT32013_H2029.pdf |
|
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. |
Humana Inc. | 25000 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25000_v2i9_02112013063949656_1.25000_12192012135612823.LT32013_H2899C.pdf | ||
|
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. |
Humana Inc. | 25001 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25001_v2i9_02112013064232492_1.25001_12192012135612823.LT32013_H2899.pdf | ||
|
H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 25008 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25008_v2i9_02112013064444611_1.25008_12192012135612823.LT32013_H4007C.pdf |
|
H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 25009 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25009_v2i9_02112013064703078_1.25009_12192012135612823.LT32013_H4007.pdf |
|
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. |
Humana Inc. | 25020 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25020_v2i9_02112013064902763_1.25020_12192012135612823.LT32013_H5578C.pdf | ||
|
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. |
Humana Inc. | 25021 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25021_v2i9_02112013065105100_1.25021_12192012135612823.LT32013_H5578.pdf | ||
|
H5700 - ARKANSAS COMMUNITY CARE, INC. |
Humana Inc. | 25022 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25022_v2i9_02112013065327717_1.25022_12192012135612823.LT32013_H5700C.pdf | ||
|
H5700 - ARKANSAS COMMUNITY CARE, INC. |
Humana Inc. | 25023 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25023_v2i9_02112013065545638_1.25023_12192012135612823.LT32013_H5700.pdf | ||
|
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. |
Humana Inc. | 25030 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25030_v2i9_02112013065820033_1.25030_12192012135612823.LT32013_H7179C.pdf | ||
|
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. |
Humana Inc. | 25031 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25031_v2i9_02112013070025646_1.25031_12192012135612823.LT32013_H7179.pdf | ||
|
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
Humana Inc. | 25040 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25040_v2i9_02112013070300291_1.25040_12192012135612823.LT32013_H4125.pdf | ||
|
H6411 - HUMANA INSURANCE COMPANY |
Humana Inc. | 25043 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25043_v2i9_02112013070559101_1.25043_12192012135612823.LT32013_H6411.pdf | ||
|
H5783 - ARCADIAN HEALTH PLAN, INC. |
Humana Inc. | 25086 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25086_v2i9_02112013070819440_1.25086_12192012135612823.LT32013_H5783.pdf | ||
|
H7731 - MD CARE, INC. |
Humana Inc. | 25118 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25118_v2i9_02112013071030825_1.25118_12192012135612823.LT32013_H7731C.pdf | ||
|
H7731 - MD CARE, INC. |
Humana Inc. | 25119 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25119_v2i9_02112013071250618_1.25119_12192012135612823.LT32013_H7731.pdf | ||
|
H3337 - LIBERTY HEALTH ADVANTAGE, INC. |
Liberty Health Advantage, Inc. | 25038 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25038_v2i9_02112013071511020_1.25038_12192012135612823.LT32013_H3337.pdf | ||
|
H2643 - LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY |
Local Initiative Health Authority for LA County | 25036 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25036_v2i9_02112013071731531_1.25036_12192012135612823.LT32013_H2643.pdf | ||
|
H5821 - MAPFRE LIFE INSURANCE COMPANY |
MAPFRE PRAICO CORPORATION | Edgardo Silva | 7872506500 | 25089 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25089_v2i9_02112013071940389_1.25089_12192012135612823.LT32013_H5821.pdf |
|
H0141 - MCLAREN HEALTH PLAN, INC. |
McLaren Health Care Corporation | 24963 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24963_v2i9_02112013072154628_1.24963_12192012135612823.LT3_2013_H0141.pdf | ||
|
H4006 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | 25065 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25065_v2i9_02112013072501051_1.25065_12192012135612823.LT32013_H4006.pdf | ||
|
H5577 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | Deliannie Gonzalez | 7877582500 | 25079 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25079_h5dv_02072013104728735_1.25079_12192012135612823.LT32013_H5577.pdf |
|
S5555 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | 25106 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25106_h5dv_02072013105415591_1.25106_12192012135612823.LT32013_S5555.pdf | ||
|
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006651029 | 24957 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24957_h5dv_02072013110528151_1.24957_12192012135612823.LT3_2013_H5823.pdf |
|
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006651029 | 24958 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24958_h5dv_02072013112709013_1.24958_12192012135612823.LT3_2013_H5823C.pdf |
|
H5628 - MOLINA HEALTHCARE OF UTAH, INC. |
Molina Healthcare, Inc. | Member Services | 8886651328 | 24975 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24975_h5dv_02072013113243811_1.24975_12192012135612823.LT3_2013_H5628.pdf |
|
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 24976 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24976_h5dv_02072013113800622_1.24976_12192012135612823.LT3_2013_H5926.pdf |
|
H5810 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | Member Services | 8006650898 | 25087 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25087_h5dv_02072013114138199_1.25087_12192012135612823.LT32013_H5810.pdf |
|
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 25098 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25098_h5dv_02072013114541689_1.25098_12192012135612823.LT32013_H7678.pdf |
|
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. |
Molina Healthcare, Inc. | 25099 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25099_h5dv_02072013114908455_1.25099_12192012135612823.LT32013_H8130.pdf | ||
|
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. |
Molina Healthcare, Inc. | 25102 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25102_h5dv_02072013115219075_1.25102_12192012135612823.LT32013_H9082.pdf | ||
|
H5162 - STERLING LIFE INSURANCE COMPANY |
Munich American Holding Corporation | 24972 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24972_h5dv_02072013115639611_1.24972_12192012135612823.LT3_2013_H5162.pdf | ||
|
H3410 - STERLING LIFE INSURANCE COMPANY |
Munich American Holding Corporation | 24986 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24986_h5dv_02072013120058676_1.24986_12192012135612823.LT3_2013_H3410.pdf | ||
|
H5006 - STERLING LIFE INSURANCE COMPANY |
Munich American Holding Corporation | 25071 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25071_h5dv_02072013120451514_1.25071_12192012135612823.LT32013_H5006.pdf | ||
|
H5698 - HARMONY HEALTH PLAN, INC. |
Munich American Holding Corporation | 25082 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25082_h5dv_02072013120844364_1.25082_12192012135612823.LT32013_H5698.pdf | ||
|
S2505 - HARMONY HEALTH PLAN, INC. |
Munich American Holding Corporation | 25105 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25105_h5dv_02072013121235504_1.25105_12192012135612823.LT32013_S2505.pdf | ||
|
H0423 - METROPLUS HEALTH PLAN, INC. |
New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 25050 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25050_h5dv_02072013134215475_1.25050_12192012135612823.LT32013_H0423.pdf |
|
S5775 - TRIPLE S SALUD, INC. |
Pharmacy Insurance Corporation of America | 25107 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25107_h5dv_02072013134721662_1.25107_12192012135612823.LT32013_S5775.pdf | ||
|
H4155 - PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY |
Public Health Trust of Miami-Dade County | 24987 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24987_h5dv_02072013135047867_1.24987_12192012135612823.LT3_2013_H4155.pdf | ||
|
H5943 - SCAN HEALTH PLAN |
SCAN Health Plan | Kim McBeath | 8777787226 | 24977 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24977_h5dv_02072013135419766_1.24977_12192012135612823.LT3_2013_H5943.pdf |
|
H9385 - SCAN HEALTH PLAN ARIZONA |
SCAN Health Plan | 24980 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24980_h5dv_02072013135734458_1.24980_12192012135612823.LT3_2013_H9385.pdf | ||
|
H2165 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 24968 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24968_v2i9_02092013164716433_1.24968_12192012135612823.LT3_2013_H2165.pdf | ||
|
H7281 - BRAVO HEALTH PENNSYLVANIA, INC. |
The Cigna Group | 25032 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25032_v2i9_02092013165312416_1.25032_12192012135612823.LT32013_H7281C.pdf | ||
|
H7281 - BRAVO HEALTH PENNSYLVANIA, INC. |
The Cigna Group | 25033 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25033_v2i9_02092013170516582_1.25033_12192012135612823.LT32013_H7281.pdf | ||
|
H0150 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY |
The Cigna Group | 25047 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25047_v2i9_02092013171317602_1.25047_12192012135612823.LT32013_H0150.pdf | ||
|
H1355 - BRAVO HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25054 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25054_v2i9_02092013172239181_1.25054_12192012135612823.LT32013_H1355.pdf | ||
|
H2108 - BRAVO HEALTH MID-ATLANTIC, INC. |
The Cigna Group | Jared Rich | 8006683813 | 25059 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25059_v2i9_02092013172956083_1.25059_12192012135612823.LT32013_H2108.pdf |
|
H3964 - BRAVO HEALTH PENNSYLVANIA, INC. |
The Cigna Group | 25063 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25063_v2i9_02092013174107021_1.25063_12192012135612823.LT32013_H3964.pdf | ||
|
H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Jared Rich | 8006683813 | 25068 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25068_v2i9_02102013152942367_1.25068_12192012135612823.LT32013_H4407.pdf |
|
S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25110 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25110_v2i9_02102013153529144_1.25110_12192012135612823.LT32013_S5932.pdf | ||
|
S5998 - BRAVO HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25114 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25114_v2i9_02102013153859434_1.25114_12192012135612823.LT32013_S5998.pdf | ||
|
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25116 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25116_v2i9_02102013154302111_1.25116_12192012135612823.LT32013_H4528C.pdf | ||
|
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | 25117 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25117_v2i9_02102013154637628_1.25117_12192012135612823.LT32013_H4528.pdf | ||
|
H3328 - THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. |
The New York State Catholic Health Plan, Inc. | 25062 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25062_h5dv_02072013140407679_1.25062_12192012135612823.LT32013_H3328.pdf | ||
|
H7352 - UNIVERSITY CARE ADVANTAGE, LLC |
The University of AZ Health Network, Inc. | 25097 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25097_h5dv_02072013145532467_1.25097_12192012135612823.LT32013_H7352.pdf | ||
|
H3327 - TOUCHSTONE HEALTH HMO, INC. |
Touchstone Health Partnership, Inc | 25037 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25037_h5dv_02072013140727893_1.25037_12192012135612823.LT32013_H3327.pdf | ||
|
H1846 - MOUNT CARMEL HEALTH INSURANCE COMPANY |
Trinity Health Corporation | Patricia Suffern | 4124780244 | 24967 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24967_h5dv_02072013141102522_1.24967_12192012135612823.LT3_2013_H1846.pdf |
|
H4005 - TRIPLE S ADVANTAGE, INC. |
Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 25064 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25064_h5dv_02072013141558397_1.25064_12192012135612823.LT32013_H4005.pdf |
|
H4012 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 25066 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25066_h5dv_02072013142119826_1.25066_12192012135612823.LT32013_H4012.pdf | ||
|
H5732 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 25083 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25083_h5dv_02072013143317876_1.25083_12192012135612823.LT32013_H5732.pdf | ||
|
H5774 - TRIPLE S ADVANTAGE, INC. |
Triple-S Management Corporation | Dionnel Perez Morales | 7877494949 | 25085 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25085_h5dv_02072013143734704_1.25085_12192012135612823.LT32013_H5774.pdf |
|
S5907 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 25109 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25109_h5dv_02072013145035328_1.25109_12192012135612823.LT32013_S5907.pdf | ||
|
H9670 - UPMC HEALTH BENEFITS, INC. |
UPMC Health System | 24993 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24993_p44x_02072013122146136_1.24993_12192012135612823.LT3_2013_H9670.pdf | ||
|
H4213 - USABLE MUTUAL INSURANCE COMPANY |
USAble Mutual Insurance Company | Customer Service | 8442014934 | 24971 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24971_h5dv_02072013145959263_1.24971_12192012135612823.LT3_2013_H4213.pdf |
|
H0624 - UnitedHealthcare Benefits of Texas, Inc. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 24965 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24965_h5dv_02072013153735675_1.24965_12192012135612823.LT3_2013_H0624.pdf |
|
H3107 - OXFORD HEALTH PLANS (NJ), INC. |
UnitedHealth Group, Inc. | 24985 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24985_h5dv_02072013154231706_1.24985_12192012135612823.LT3_2013_H3107.pdf | ||
|
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006901606 | 24994 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24994_h5dv_02072013154613277_1.24994_12192012135612823.LT32013_H0251C.pdf |
|
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006901606 | 24995 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24995_h5dv_02072013155023521_1.24995_12192012135612823.LT32013_H0251.pdf |
|
H3164 - AMERICHOICE OF NEW JERSEY, INC |
UnitedHealth Group, Inc. | 25002 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25002_h5dv_02072013155353860_1.25002_12192012135612823.LT32013_H3164C.pdf | ||
|
H3164 - AMERICHOICE OF NEW JERSEY, INC |
UnitedHealth Group, Inc. | 25003 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25003_h5dv_02072013155733840_1.25003_12192012135612823.LT32013_H3164.pdf | ||
|
H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 25006 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25006_h5dv_02072013160100232_1.25006_12192012135612823.LT32013_H3387C.pdf |
|
H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 25007 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25007_h5dv_02072013160446889_1.25007_12192012135612823.LT32013_H3387.pdf |
|
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | 25012 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25012_h5dv_02072013160834170_1.25012_12192012135612823.LT32013_H4406C.pdf | ||
|
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. |
UnitedHealth Group, Inc. | 25013 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25013_h5dv_02072013161212184_1.25013_12192012135612823.LT32013_H4406.pdf | ||
|
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC |
UnitedHealth Group, Inc. | 25028 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25028_h5dv_02072013161547203_1.25028_12192012135612823.LT32013_H6952C.pdf | ||
|
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC |
UnitedHealth Group, Inc. | 25029 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25029_h5dv_02072013162038070_1.25029_12192012135612823.LT32013_H6952.pdf | ||
|
H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. |
UnitedHealth Group, Inc. | 25039 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25039_h5dv_02072013162404899_1.25039_12192012135612823.LT32013_H3920.pdf | ||
|
R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. |
UnitedHealth Group, Inc. | 25045 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25045_h5dv_02072013162747995_1.25045_12192012135612823.LT32013_R5674.pdf | ||
|
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY |
UnitedHealth Group, Inc. | 25046 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25046_h5dv_02072013163956905_1.25046_12192012135612823.LT32013_H0084.pdf | ||
|
H0151 - UNITEDHEALTHCARE OF ALABAMA, INC. |
UnitedHealth Group, Inc. | 25048 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25048_h5dv_02082013064638875_1.25048_12192012135612823.LT32013_H0151.pdf | ||
|
H0321 - ARIZONA PHYSICIANS IPA, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8776140623 | 25049 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25049_h5dv_02082013064942959_1.25049_12192012135612823.LT32013_H0321.pdf |
|
H1108 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 25051 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25051_h5dv_02082013065236590_1.25051_12192012135612823.LT32013_H1108.pdf | ||
|
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 25052 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25052_h5dv_02082013071726637_1.25052_12192012135612823.LT32013_H1111.pdf | ||
|
H1717 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 25056 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25056_h5dv_02082013071610149_1.25056_12192012135612823.LT32013_H1717.pdf | ||
|
H2182 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 25060 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25060_h5dv_02082013071506187_1.25060_12192012135612823.LT32013_H2182.pdf | ||
|
H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 25069 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25069_h5dv_02082013071357842_1.25069_12192012135612823.LT32013_H4514.pdf |
|
H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | 25070 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25070_h5dv_02082013070800876_1.25070_12192012135612823.LT32013_H4837.pdf | ||
|
H5407 - CITRUS HEALTH CARE, INC. |
UnitedHealth Group, Inc. | 25075 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25075_h5dv_02082013071248078_1.25075_12192012135612823.LT32013_H5407.pdf | ||
|
H5440 - UNITEDHEALTHCARE INSURANCE COMPANY |
UnitedHealth Group, Inc. | 25076 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25076_h5dv_02082013072035744_1.25076_12192012135612823.LT32013_H5440.pdf | ||
|
H6528 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 25093 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25093_h5dv_02082013072342916_1.25093_12192012135612823.LT32013_H6528.pdf | ||
|
H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. |
UnitedHealth Group, Inc. | 25101 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25101_h5dv_02082013072646656_1.25101_12192012135612823.LT32013_H9011.pdf | ||
|
R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | UHC Customer Service | 8006434845 | 25103 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25103_h5dv_02082013072952706_1.25103_12192012135612823.LT32013_R6801.pdf |
|
R9896 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. |
UnitedHealth Group, Inc. | 25115 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25115_h5dv_02082013073252733_1.25115_12192012135612823.LT32013_R9896.pdf | ||
|
H6169 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 24959 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24959_h5dv_02082013073649561_1.24959_12192012135612823.LT3_2013_H6169C.pdf | ||
|
H6169 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 24960 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24960_h5dv_02082013074014830_1.24960_12192012135612823.LT3_2013_H6169.pdf | ||
|
H5378 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 25014 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25014_h5dv_02082013074252221_1.25014_12192012135612823.LT32013_H5378C.pdf | ||
|
H5378 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 25015 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25015_h5dv_02082013074600158_1.25015_12192012135612823.LT32013_H5378.pdf | ||
|
H5421 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 25016 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25016_h5dv_02082013074958968_1.25016_12192012135612823.LT32013_H5421C.pdf | ||
|
H5421 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 25017 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25017_h5dv_02082013075315859_1.25017_12192012135612823.LT32013_H5421.pdf | ||
|
H5656 - SELECTCARE HEALTH PLANS, INC. |
Universal American Corp. | 25080 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25080_h5dv_02082013075637087_1.25080_12192012135612823.LT32013_H5656.pdf | ||
|
H0838 - UNIVERSAL CARE, INC. |
Universal Care, Inc | 24983 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24983_h5dv_02082013075948051_1.24983_12192012135612823.LT3_2013_H0838.pdf | ||
|
H8098 - UNIVERSAL HEALTH CARE INSURANCE COMPANY |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24961 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24961_h5dv_02082013080902766_1.24961_12192012135612823.LT3_2013_H8098.pdf |
|
H8098 - UNIVERSAL HEALTH CARE INSURANCE COMPANY |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24962 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24962_h5dv_02082013081232996_1.24962_12192012135612823.LT3_2013_H8098C.pdf |
|
H6705 - UNIVERSAL HEALTH CARE OF NEVADA, INC. |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24979 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24979_h5dv_02082013081602913_1.24979_12192012135612823.LT3_2013_H6705.pdf |
|
H5429 - UNIVERSAL HEALTH CARE, INC. |
Universal Health Care Group, Inc. | 25018 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25018_h5dv_02082013081857668_1.25018_12192012135612823.LT32013_H5429C.pdf | ||
|
H5429 - UNIVERSAL HEALTH CARE, INC. |
Universal Health Care Group, Inc. | 25019 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25019_h5dv_02082013082148023_1.25019_12192012135612823.LT32013_H5429.pdf | ||
|
H5820 - UNIVERSAL HEALTH CARE INSURANCE COMPANY |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25024 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25024_p44x_02072013115721332_1.25024_12192012135612823.LT32013_H5820C.pdf |
|
H5820 - UNIVERSAL HEALTH CARE INSURANCE COMPANY |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25025 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25025_p44x_02072013120820245_1.25025_12192012135612823.LT32013_H5820.pdf |
|
H5404 - UNIVERSAL HEALTH CARE, INC. |
Universal Health Care Group, Inc. | 25074 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25074_p44x_02072013121343850_1.25074_12192012135612823.LT32013_H5404.pdf | ||
|
H6642 - UNIVERSAL HMO OF TEXAS, INC. |
Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25094 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25094_p44x_02072013121753581_1.25094_12192012135612823.LT32013_H6642.pdf |
|
H5985 - PHOENIX HEALTH PLANS, INC. |
Vanguard Health Systems | 24991 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24991_p44x_02072013122555461_1.24991_12192012135612823.LT3_2013_H5985.pdf | ||
|
H5549 - VNS CHOICE |
Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 25078 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25078_p44x_02072013122906362_1.25078_12192012135612823.LT32013_H5549.pdf |
|
H3361 - WELLCARE OF NEW YORK, INC. |
WellCare Health Plans, Inc. | 24955 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24955_p44x_02072013123218121_1.24955_12192012135612823.LT3_2013_H3361.pdf | ||
|
H3361 - WELLCARE OF NEW YORK, INC. |
WellCare Health Plans, Inc. | 24956 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24956_p44x_02072013123512797_1.24956_12192012135612823.LT3_2013_H3361C.pdf | ||
|
H0712 - WELLCARE OF CONNECTICUT, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24966 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24966_p44x_02072013123801983_1.24966_12192012135612823.LT3_2013_H0712.pdf |
|
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24969 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24969_p44x_02072013124301633_1.24969_12192012135612823.LT3_2013_H2491.pdf |
|
H1112 - WELLCARE OF GEORGIA, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24984 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24984_p44x_02072013131138477_1.24984_12192012135612823.LT3_2013_H1112.pdf |
|
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. |
WellCare Health Plans, Inc. | 24996 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24996_p44x_02072013131511375_1.24996_12192012135612823.LT32013_H1216C.pdf | ||
|
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. |
WellCare Health Plans, Inc. | 24997 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24997_p44x_02072013133144771_1.24997_12192012135612823.LT32013_H1216.pdf | ||
|
H0117 - WELLCARE OF OHIO, INC. |
WellCare Health Plans, Inc. | 25034 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25034_p44x_02072013133927538_1.25034_12192012135612823.LT32013_H0117.pdf | ||
|
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 25035 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25035_p44x_02072013134252853_1.25035_12192012135612823.LT32013_H0913.pdf |
|
H1264 - WELLCARE OF TEXAS, INC. |
WellCare Health Plans, Inc. | 25053 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25053_p44x_02072013134547405_1.25053_12192012135612823.LT32013_H1264.pdf | ||
|
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. |
WellCare Health Plans, Inc. | 25058 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25058_p44x_02072013135229534_1.25058_12192012135612823.LT32013_H1903.pdf | ||
|
H1016 - AVMED, INC. |
AvMed, Inc. | Catherine Lojko | 3523728400 | 23570 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23570_p44x_02092013175214745_1.b5ws_09052012112019275.SII_2012_H1016.pdf |
|
H4152 - BLUE CROSS & BLUE SHIELD OF RHODE ISLAND |
Blue Cross & Blue Shield of Rhode Island | Ivona Wisniewski | 4014591721 | 23995 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | 23995_p44x_02092013175720527_1.b5ws_09242012150554217_1.SII_2012_H4152.pdf |
|
S5937 - LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY |
BlueCross BlueShield of Louisiana | 23999 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | 23999_p44x_02092013180051084_1.b5ws_09242012151116236_1.SII_2012_S5937.pdf | ||
|
H0571 - CHINESE COMMUNITY HEALTH PLAN |
Chinese Hospital Association | Youngsoo Cho | 6282283375 | 23569 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23569_p44x_02092013180400175_1.b5ws_09052012111846173.SII_2012_H0571.pdf |
|
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON |
Community Health Plan of Washington | Customer Care | 8009420247 | 23998 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | 23998_p44x_02092013180832338_1.b5ws_09242012150937066_1.SII_2012_H5826.pdf |
|
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION |
Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 23577 | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23577_p44x_02092013181204845_1.b5ws_09052012130232110.SII_2012_S5877.pdf |
|
H5887 - MMM HEALTHCARE, LLC. |
First Medical Health Plan, Inc. | 23574 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23574_p44x_02092013181601094_1.b5ws_09052012125403109.SII_2012_H5887.pdf | ||
|
S5840 - FIRST MEDICAL HEALTH PLAN, INC. |
First Medical Health Plan, Inc. | 23576 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23576_p44x_02092013181926515_1.b5ws_09052012130031674.SII_2012_S5840.pdf | ||
|
H4011 - MMM HEALTHCARE, LLC |
First Medical Health Plan, Inc. | 23599 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23599_p44x_02092013182405575_1.b5ws_09052012121605091.SII_2012_H4011.pdf | ||
|
H5821 - MAPFRE LIFE INSURANCE COMPANY |
MAPFRE PRAICO CORPORATION | Edgardo Silva | 7872506500 | 23997 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | 23997_p44x_02092013182852755_1.b5ws_09242012150741281_1.SII_2012_H5821.pdf |
|
S5555 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | 23575 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23575_p44x_02092013183228126_1.b5ws_09052012125625185.SII_2012_S5555.pdf | ||
|
H4006 - MCS ADVANTAGE, INC. |
Medical Card System, Inc. | 23598 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23598_p44x_02092013183552041_1.b5ws_09052012121418714.SII_2012_H4006.pdf | ||
|
H2701 - NEW WEST HEALTH SERVICES |
New West Health Services | 23571 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23571_p44x_02092013183856298_1.b5ws_09052012112327708.SII_2012_H2701.pdf | ||
|
H0423 - METROPLUS HEALTH PLAN, INC. |
New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 23568 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23568_p44x_02092013184157433_1.b5ws_09052012111610656.SII_2012_H0423.pdf |
|
H3327 - TOUCHSTONE HEALTH HMO, INC. |
Touchstone Health Partnership, Inc | 23572 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23572_p44x_02092013184510627_1.b5ws_09052012112535255.SII_2012_H3327.pdf | ||
|
H4005 - TRIPLE S ADVANTAGE, INC. |
Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 23573 | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23573_p44x_02092013184834430_1.b5ws_09052012112737435.SII_2012_H4005.pdf |
|
H4012 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 23600 * | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23600_p44x_02092013185332364_1.b5ws_09052012121913399.SII_2012_H4012.pdf | ||
|
H5732 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 23601 * | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | 23601_p44x_02092013185715121_1.b5ws_09052012122047140.SII_2012_H5732.pdf | ||
|
H0318 - AETNA HEALTH, INC. (PA) H0523 - AETNA HEALTH OF CALIFORNIA INC. H0901 - AETNA HEALTH, INC. (PA) H1109 - AETNA HEALTH INC.(GA) H1110 - AETNA LIFE INSURANCE COMPANY H1419 - AETNA HEALTH, INC. (PA) H2112 - AETNA HEALTH, INC. (PA) H3152 - AETNA HEALTH INC. (NJ) H3312 - AETNA HEALTH INC. (NY) H3597 - AETNA HEALTH INC. (ME) H3623 - AETNA HEALTH, INC. (PA) H3931 - AETNA HEALTH INC. (PA) H4523 - AETNA HEALTH INC. (TX) H4524 - AETNA LIFE INSURANCE COMPANY H4910 - AETNA HEALTH, INC. (PA) H5414 - AETNA HEALTH INC. (FL) H5521 - AETNA LIFE INSURANCE COMPANY H5793 - AETNA HEALTH INC. (CT) H5813 - AETNA HEALTH, INC. (PA) H5832 - AETNA HEALTH, INC. (PA) H5950 - AETNA HEALTH, INC. (PA) H6923 - AETNA HEALTH, INC. (PA) H7908 - AETNA HEALTH, INC. (PA) H8684 - AETNA LIFE INSURANCE COMPANY S5810 - WELLCARE PRESCRIPTION INSURANCE, INC. |
Aetna Inc. | Aetna Customer Service | 8006240756 | 23401 | 19-JUL-2012 | Drug Benefit | Formulary Submission and Administration | Jan.-Mar. 2012 Audit of Aetna's formulary administration revealed significant compliance problems regarding formulary and benefit administration including transition policy implementation failures. | 23401_p44x_02072013162545225_1.s2k1_08162012122327527.AetnaCAP-corrected-07192012.pdf |
|
H0151 - UNITEDHEALTHCARE OF ALABAMA, INC. H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H0303 - PACIFICARE OF ARIZONA, INC. H0316 - UNITEDHEALTHCARE OF ARIZONA, INC. H0319 - UNITEDHEALTHCARE INSURANCE COMPANY H0321 - ARIZONA PHYSICIANS IPA, INC. H0401 - UNITEDHEALTHCARE OF ARKANSAS, INC. H0408 - UNITEDHEALTHCARE INSURANCE COMPANY H0543 - UHC OF CALIFORNIA H0609 - UnitedHealthcare Benefits of Texas, Inc. H0620 - UNITEDHEALTHCARE INSURANCE COMPANY H0624 - UnitedHealthcare Benefits of Texas, Inc. H0710 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H0752 - OXFORD HEALTH PLANS (CT), INC. H0755 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H1080 - UNITEDHEALTHCARE OF FLORIDA, INC. H1108 - UNITEDHEALTHCARE INSURANCE COMPANY H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H1286 - UNITEDHEALTHCARE OF OREGON, INC. H1303 - UNITEDHEALTHCARE INSURANCE COMPANY H1509 - UNITEDHEALTHCARE INSURANCE COMPANY H1717 - UNITEDHEALTHCARE INSURANCE COMPANY H1944 - UNITEDHEALTHCARE OF WISCONSIN, INC. H2001 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H2111 - UNITEDHEALTHCARE INSURANCE COMPANY H2182 - UNITEDHEALTHCARE INSURANCE COMPANY H2226 - UNITEDHEALTHCARE INSURANCE COMPANY H2228 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H2406 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H2654 - UNITEDHEALTHCARE OF THE MIDWEST, INC. H2802 - UNITEDHEALTHCARE OF THE MIDLANDS, INC. H2803 - UNITEDHEALTHCARE INSURANCE COMPANY H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H2931 - HEALTH PLAN OF NEVADA, INC. H3107 - OXFORD HEALTH PLANS (NJ), INC. H3113 - OXFORD HEALTH PLANS (NJ), INC. H3164 - AMERICHOICE OF NEW JERSEY, INC H3209 - UNITEDHEALTHCARE INSURANCE COMPANY H3307 - OXFORD HEALTH PLANS (NY), INC. H3379 - UNITEDHEALTHCARE OF NEW YORK, INC. H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. H3456 - UNITEDHEALTHCARE OF NORTH CAROLINA, INC. H3659 - UNITEDHEALTHCARE OF OHIO, INC. H3749 - UNITEDHEALTHCARE OF WISCONSIN, INC. H3805 - UnitedHealthcare Benefits of Texas, Inc. H3812 - UNITEDHEALTHCARE INSURANCE COMPANY H3887 - UNITEDHEALTHCARE OF THE MIDWEST, INC. H3912 - UNITEDHEALTHCARE INSURANCE COMPANY H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. H3921 - UNITEDHEALTHCARE INSURANCE COMPANY H4102 - UNITEDHEALTHCARE OF NEW ENGLAND, INC. H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H4456 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. H4522 - UNITEDHEALTHCARE INSURANCE COMPANY H4527 - PHYSICIANS HEALTH CHOICE OF TEXAS, LLC H4590 - UNITEDHEALTHCARE BENEFITS OF TEXAS, INC. H4604 - UNITEDHEALTHCARE OF THE ROCKIES, INC. H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. H4971 - UNITEDHEALTHCARE INSURANCE COMPANY H5005 - UNITEDHEALTHCARE OF WASHINGTON, INC. H5008 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H5253 - UNITEDHEALTHCARE OF WISCONSIN, INC. H5407 - CITRUS HEALTH CARE, INC. H5417 - UNITEDHEALTHCARE INSURANCE COMPANY H5424 - UNITEDHEALTHCARE INSURANCE COMPANY H5435 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H5440 - UNITEDHEALTHCARE INSURANCE COMPANY H5507 - UNITEDHEALTHCARE INSURANCE COMPANY H5516 - UNITEDHEALTHCARE INSURANCE COMPANY H5532 - UNITEDHEALTHCARE INSURANCE COMPANY H5652 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H5749 - UNITEDHEALTHCARE INSURANCE COMPANY H5998 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC H7187 - UNITEDHEALTHCARE OF WISCONSIN, INC. H7949 - PACIFICARE OF NEVADA, INC. H8748 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. R3175 - UNITEDHEALTHCARE INSURANCE COMPANY R5287 - UNITEDHEALTHCARE INSURANCE COMPANY R5342 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. R7444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. S5805 - UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK S5820 - UNITEDHEALTHCARE INSURANCE COMPANY S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY |
UnitedHealth Group, Inc. | UHC Customer Service | 8006434845, 8006901606, 8007110646, 8448766176, 8663148188, 8664608854, 8664801086, 8665798774, 8666228054, 8668709604, 8773703249, 8776140623, 8888675511, 8888675575 | 22921 | 19-JUN-2012 | Drug Benefit | Formulary Submission and Administration | United failed to follow CMS requirements in regard to formulary and benefit administration. | 22921_p44x_02082013121706229_1.s2k1_07092012160153424.United Corrective Action Plan Request 06-19-12.pdf |
|
H1419 - AETNA HEALTH, INC. (PA) |
Aetna Inc. | 23263 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23263_p44x_02072013151704717_1.b5i2_08062012151933297.LPI_H1419.pdf | ||
|
H4524 - AETNA LIFE INSURANCE COMPANY |
Aetna Inc. | 23268 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23268_p44x_02072013153229815_1.b5i2_08062012155516457.LPI_H4524.pdf | ||
|
H5414 - AETNA HEALTH INC. (FL) |
Aetna Inc. | 23269 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23269_p44x_02072013153709466_1.b5i2_08062012161829836.LPI_H5414.pdf | ||
|
H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. |
Central Health Plan of California | Marketing Department | 6263882390 | 23274 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23274_p44x_02072013154117339_1.b5i2_08062012163753657.LPI_H5649.pdf |
|
H7015 - HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. |
HF Management Services, LLC | 23306 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23306_p44x_02072013154412281_1.b5i2_08062012171605592.LPI_H7015.pdf | ||
|
S3440 - ALLIANCE HEALTH AND LIFE INSURANCE COMPANY |
Health Alliance Plan (HAP) | 23309 * | 31-MAY-2012 | Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23309_p44x_02072013154748439_1.b5i2_08062012173001622.LPI_S3440.pdf | ||
|
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. |
Humana Inc. | 23264 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23264_p44x_02072013155054270_1.b5i2_08062012152541317.LPI_H2899.pdf | ||
|
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. |
Humana Inc. | 23273 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23273_p44x_02072013155511269_1.b5i2_08062012163453459.LPI_H5578.pdf | ||
|
H5700 - ARKANSAS COMMUNITY CARE, INC. |
Humana Inc. | 23303 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23303_p44x_02072013155820813_1.b5i2_08062012170248796.LPI_H5700.pdf | ||
|
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. |
Humana Inc. | 23307 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23307_p44x_02072013162021331_1.b5i2_08062012172306657.LPI_H7179.pdf | ||
|
H7731 - MD CARE, INC. |
Humana Inc. | 23308 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23308_p44x_02072013163716866_1.b5i2_08062012172547760.LPI_H7731.pdf | ||
|
H3337 - LIBERTY HEALTH ADVANTAGE, INC. |
Liberty Health Advantage, Inc. | 23265 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23265_p44x_02072013164146036_1.b5i2_08062012153210040.LPI_H3337.pdf | ||
|
H5810 - MOLINA HEALTHCARE OF CALIFORNIA |
Molina Healthcare, Inc. | Member Services | 8006650898 | 23305 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23305_p44x_02072013164517332_1.b5i2_08062012171041326.LPI_H5810.pdf |
|
H5698 - HARMONY HEALTH PLAN, INC. |
Munich American Holding Corporation | 23302 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23302_p44x_02072013164915708_1.b5i2_08062012165954152.LPI_H5698.pdf | ||
|
H4012 - TRIPLE-S SALUD, INC. |
Triple-S Management Corporation | 23267 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23267_p44x_02072013165328277_1.b5i2_08062012155142282.LPI_H4012.pdf | ||
|
H5774 - TRIPLE S ADVANTAGE, INC. |
Triple-S Management Corporation | Dionnel Perez Morales | 7877494949 | 23304 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23304_p44x_02072013165700941_1.b5i2_08062012170710989.LPI_H5774.pdf |
|
H3164 - AMERICHOICE OF NEW JERSEY, INC |
UnitedHealth Group, Inc. | 23141 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23141_p44x_02082013100415197_1.b5i2_07262012160038425.LPI_H3164.pdf | ||
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H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. |
UnitedHealth Group, Inc. | 23142 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23142_p44x_02082013100855971_1.b5i2_07262012160737275.LPI_H3920.pdf | ||
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R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. |
UnitedHealth Group, Inc. | 23143 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23143_p44x_02082013101524621_1.b5i2_07262012161112074.LPI_R5674.pdf | ||
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H5407 - CITRUS HEALTH CARE, INC. |
UnitedHealth Group, Inc. | 23144 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23144_p44x_02082013102544858_1.b5i2_07262012161339808.LPI_H5407.pdf | ||
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H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. |
UnitedHealth Group, Inc. | UHC Customer Service | 8664801086 | 23145 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23145_p44x_02082013103124664_1.b5i2_07262012161520554.LPI_H4514.pdf |
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H3706 - GLOBALHEALTH, INC. |
Universal American Corp. | Daniel Thomas | 4055261126 | 23266 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23266_p44x_02082013103714890_1.b5i2_08062012154933798.LPI_H3706.pdf |
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H5421 - THE PYRAMID LIFE INSURANCE COMPANY |
Universal American Corp. | 23270 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23270_p44x_02082013104301234_1.b5i2_08062012162239548.LPI_H5421.pdf | ||
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H5656 - SELECTCARE HEALTH PLANS, INC. |
Universal American Corp. | 23301 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23301_p44x_02082013104622043_1.b5i2_08062012165432944.LPI_H5656.pdf | ||
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H5429 - UNIVERSAL HEALTH CARE, INC. |
Universal Health Care Group, Inc. | 23271 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23271_p44x_02082013105018856_1.b5i2_08062012163059347.LPI_H5429.pdf | ||
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H5549 - VNS CHOICE |
Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 23272 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | 23272_p562_05162013132907108_1.LPI_H5549.pdf |
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H0117 - WELLCARE OF OHIO, INC. |
WellCare Health Plans, Inc. | 23261 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23261_p562_05162013131710324_1.LPI_H0117.pdf | ||
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H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. |
WellCare Health Plans, Inc. | 23262 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23262_p562_05162013132438103_1.LPI_H1216.pdf | ||
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H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. |
WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 23281 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | 23281_p562_05162013132157736_1.LPI_H0913.pdf |
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H0564 - BLUE CROSS OF CALIFORNIA H1517 - ANTHEM INSURANCE COMPANIES, INC. H1607 - ANTHEM INSURANCE COMPANIES, INC. H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. H2836 - ANTHEM HEALTH PLANS, INC. H2997 - ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC. H3342 - ANTHEM HEALTHCHOICE ASSURANCE, INC. H3370 - EMPIRE HEALTHCHOICE HMO, INC. H3655 - COMMUNITY INSURANCE COMPANY H4036 - ANTHEM INSURANCE COMPANIES, INC. H4909 - ANTHEM INSURANCE COMPANIES, INC. H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA H5529 - COMMUNITY INSURANCE COMPANY H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. H5679 - HMO COLORADO, INC. H5854 - ANTHEM HEALTH PLANS, INC. H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. R5941 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 21826 | 28-FEB-2012 | Health and Drug Benefit | Bid Submission | Actuarial deficiencies regarding bids submission. | 21826_p44x_02082013111133409_1.n2wm_02292012170344352.OACT 2012 - Wellpoint Final Email Ready.pdf |
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H4155 - PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY |
Public Health Trust of Miami-Dade County | 21824 * | 28-FEB-2012 | Health and Drug Benefit | Bid Submission | Actuarial issues regarding bids. | 21824_p44x_02082013110732618_1.n2wm_02292012165555843.OACT 2012 - Public Health Trust of Miami-Dade County Final Email Ready.pdf | ||
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H5590 - Bridgeway Health Solutions of Arizona, Inc. |
Centene Corporation | Provider Services | 8773915921 | 20980 | 06-JAN-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Failure to submit 4Rx data in a timely manner for the 2012 plan year. | 20980_p44x_02112013095759475_1.m5nx_01122012094621597.FinalCAP 4Rx letter 162012 H5590.pdf |
| Report Created: 6/1/2024 | Report Sorted: Descending by Date Letter Sent | ||||||||
| Compliance Issue IDs followed by an asterisk (*) indicate that all contracts assigned to the issue have been terminated as of the report creation date | |||||||||
| Ad-Hoc CAPs refers to CAPs issued by CMS that are not included in audit reports | |||||||||