Ritter Insurance Marketing, Craig Ritter

Sanctions Against Cigna to Continue into AEP

Annual Enrollment 2016 is coming, but Cigna will be spending this one on the bench as CMS sanctions to their MAPD program continue.

The Centers for Medicare and Medicaid Services red-shirted the Connecticut-based company back in January citing, “widespread and systemic failures.” In a recent regulatory filing, Cigna admitted that they “probably can’t fix the problems in time for the enrollment season.”

January’s ban came when CMS determined that “Cigna’s conduct poses a serious threat to the health and safety of Medicare beneficiaries.” CMS found problems with Cigna’s prescription drug coverage and how they handled appeals and grievances.

The sanctions against Cigna prevent the insurer from enrolling any new customers into their Medicare Advantage or prescription drug plans. Current Cigna plan members are able to keep their coverage for 2017, should they choose to do so. If you have clients enrolled with Cigna, you must certify for 2017 in order to receive renewal commissions.

Cigna’s Q2 report claimed 533,000 beneficiaries in MA plans and 1.04 million in PDPs.

Historically, CMS restrictions have taken about a year for insurers to resolve. Aetna’s ban lasted 14 months while Health Net Incorporated suffered a 10-month ban.

Posted by filed under Cigna, CMS, Medicare Advantage, News, Part D .


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