The Centers for Medicare & Medicaid Services (CMS) has informed Florida Healthcare Plus, Inc. of an immediate intermediate sanction on the Medicare Advantage-Prescription Drug Plan (MA-PD) under contract H4199.
This intermediate sanction will consist of the suspension of the enrollment of Medicare beneficiaries. The sanction will remain in effect until CMS receives notification from the State of Florida that Florida Healthcare’s certificate of authority is released from suspension.
Summary of NoncomplianceFlorida Healthcare is licensed under Chapter 641, Florida Statutes and is required under 42 C.F.R. § 422.400(a) and § 423.401(a) to maintain its license in good standing. On September 29, 2014, the Florida Office of Insurance Regulation filed the FINAL ORDER OF SUSPENSION FLORIDA HEALTHCARE PLUS, INC., which states in part that , “The certificate of authority of Florida Healthcare is suspended as of close of business on September 23, 2014, and their authority to enroll new subscribers is immediately suspended.” Pursuant to 42 C.F.R. § 422.504(a)(1) and 423.505(b)(2), organizations that contract with CMS to offer MA-PDs must accept new enrollments. Therefore, Florida Healthcare is noncompliant with CMS’s contract requirements.
The official CMS letter