Released: March 3, 2009

The Centers for Medicare & Medicaid Services (CMS) recently announced it has suspended marketing and enrollment for WellCare’s Medicare Advantage Health Plans and Part D Prescription Drug Plans contracts, effective March 7, 2009. WellCare will be forced to stop marketing its Medicare Advantage Health Plans and Part D Prescription Drug Plans and stop enrolling new beneficiaries. But, beneficiaries currently enrolled in WellCare’s Medicare Advantage Health Plans and Part D Prescription Drug Plans will not see changes in their current services, and they will not lose any of their Medicare coverage.

“Although this is unfortunate for WellCare, the good news is that Louisiana WellCare customers do not need to be concerned about their benefits being altered in any way,” said Insurance Commissioner Jim Donelon. “We have about 4,170 people enrolled in WellCare’s Medicare Advantage Health Plans in 20 mostly southern parishes and thousands of people from across the state enrolled in their Part D Prescription Drug Plans. None of these people will be impacted by this CMS order on WellCare. Their services will continue with no changes.”

WellCare was recently cited by CMS for deficiencies in areas including enrollment and disenrollment operations, and appeals and grievances. They were also engaging in door-to-door solicitation, among other violations. These sanctions will remain in effect until CMS is satisfied that the deficiencies have been corrected.

WellCare provides managed care services exclusively for government-sponsored health insurance programs such as Medicare and Medicaid and had more than 2.5 million members, nationwide, as of September 30, 2008. Company officials say CMS’s action doesn’t affect its Medicaid and S-CHIP plans.

Also, anyone who currently has a Medicare Advantage Health Plan with any company has until March 31, 2009 to switch from their current plan to a similar or “like plan” under the Medicare open enrollment “like plan switching period.”

If anyone has questions regarding the CMS suspension of new enrollments and marketing practices by WellCare, they should call the Department of Insurance SHIIP program at 1-800-259-5301, option 2, WellCare at 1-888-423-5252 or Medicare at 1-800-MEDICARE.