The Centers for Medicare & Medicaid Services (CMS) is imposing intermediate sanctions on Torchmark Corporation and its carriers First United Life Insurance and United American Insurance Company. Due to several noncompliance issues, CMS has placed a suspension on Torchmark’s enrollment of beneficiaries and marketing to beneficiaries for Prescription Drug Plan Contract Numbers S5580 and S5755. The suspension is effective as of August 1, 2015, and will continue until Torchmark has corrected its compliance violations.
According to CMS, a May 2015 audit concluded “that Torchmark substantially failed to comply with CMS requirements regarding Part D coverage determinations, appeals and grievances. CMS found that Torchmark’s failures in these areas were widespread and systemic, and have remained uncorrected for more than two years despite numerous warnings and opportunities to correct. These violations resulted in enrollees experiencing delays in receiving coverage decisions, improper reviews of their coverage requests, and inappropriate and untimely resolution of their grievances.”
To regain compliance, Torchmark must submit to CMS a Corrective Action Plan and attestation stating that “Torchmark has corrected the deficiencies that are the basis for the sanction and they are not likely to recur.”