Ad-Hoc CAP Summary Report - May 2026 |
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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 |
|---|---|---|---|---|---|---|---|---|---|
|
H0613 - TOTAL LONGTERM CARE, INC. H1239 - INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC H5213 - TOTAL COMMUNITY CARE, L.L.C. H8655 - INNOVAGE VIRGINIA PACE II, LLC |
Total Community Options, Inc. | Lisa Henry | 7207209313 | 90031 | 09-APR-2026 | Health Benefit | PACE-specific Issues | The organization is out of compliance with these PACE requirements because the organization improperly charged post-eligibility treatment of income (PETI) to 18 non-Medicaid participants between July 2015 and July 2025. | Ad-Hoc CAP-letter.pdf |
|
H3810 - ALLCARE HEALTH PLAN, INC. |
AllCare Health, Inc. | Nicole LaFond | 8884600185 | 89932 | 26-FEB-2026 | Health and Drug Benefit | Accuracy & Accessibility Study | LEP 2025 CAP | Ad-Hoc CAP-letter.pdf |
|
H0137 - COMMONWEALTH CARE ALLIANCE, INC. H2225 - COMMONWEALTH CARE ALLIANCE, INC. |
CareSource | Member Services | 8664209332 | 80970 | 26-FEB-2026 | Health Benefit | Claims Processing |
Commonwealth Care Alliance (CCA) Claims Payment Inaccuracies related to Claims Vendor Transition: On April 29, 2024, CCA disclosed to their AM that they have identified multiple issues with the data CCA provided to their Part C claims vendor which is causing inaccurate and untimely payments of part C claims affecting contracts H0137, H2225, H9876, and H0876 since its April of 2023 transition to the new claim's vendor Cognizant. The plan stated as they analyzed Q3 and Q4 2024 claims in response to similar provider complaints, four distinct areas were identified as the cause for the claims issues: provider contract misconfiguration-providers were reimbursed inconsistent with contracted rates, inaccurate provider data management-causing claims associated with affected providers to pend failing to pay or deny, and payment inaccuracies, duplicate payments-paying claims more than once, and not applying Massachusetts Medicaid edits within the claims system. To remediate this issue CCA will conduct a full provider review to understand the scale of over and under payments which will include assessing all applicable edits, providing CMS a preliminary financial impact by March 29, 2024. CCA will implement all edits and provide data mapping and remediation by April 3-, 2024. All provider contract configurations will be corrected by May 31, 2024. The AM team has attempted to work with CCA to remediate member and provider claims payment CTM trends since the claims transition, the plan has stated these post transition issues were remediated but this overall identification of larger scale issues does align with what the team has seen in complaints. |
Ad-Hoc CAP-letter.pdf |
|
H3811 - SAMARITAN HEALTH PLANS, INC. |
Samaritan Health Services, Inc. | Tom Loach | 2089956866 | 89933 | 26-FEB-2026 | Health Benefit | Accuracy & Accessibility Study | TTY 2025 CAP | Ad-Hoc CAP-letter.pdf |
|
H7114 - VALIR PACE |
Valir PACE, LLC. | Dawna Williams | 4056093688 | 89935 | 26-FEB-2026 | Health Benefit | PACE-specific Issues | Organization is out of compliance with these PACE requirements because your organization failed to provide approved home care services to participants since January 2025. | Ad-Hoc CAP-letter.pdf |
|
H3814 - ATRIO HEALTH PLANS H5995 - ATRIO HEALTH PLANS H6743 - ATRIO HEALTH PLANS H7006 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 81530 | 18-FEB-2026 | Health Benefit | Payment to Providers | ATRIO Health Plan (H3818, H5995 & H6743) Failure to process Par, Non-Par, and Direct Member Remittance (DMR) Part C Provider Claims Timely - On March 4, 2024, ATRIO reported a claims processing issue to its CMS Account Manager. On February 19, 2024, the ATRIO claims team determined that Allymar, ATRIO's contractor for claims processing, was not processing 95% of its non-contract provider, clean claims within 30 days. ATRIO cites the root cause as either a systems issue. Specifically, contracted providers were erroneously tagged as non-par and vice versa, claims did not get fully processed, claims contained incorrect benefit cost sharing, and erroneous claim denials. To date, the total impact reflects 6,443 claims, impacting 5,026 beneficiaries and 632 providers. ATRIO is working with Allymar to resolve these issues and comply with the claims payment provision. As of August 30, 2024, all unpaid non compliant non par clean claims have been paid according to the plan. (Rita Fryar, AM; Estavan Carter III, DD) | Ad-Hoc CAP-letter.pdf |
|
H3814 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 89743 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H5995 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 89746 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H6743 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 89771 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H7006 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 89774 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H3814 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 89789 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H3810 - ALLCARE HEALTH PLAN, INC. |
AllCare Health, Inc. | Nicole LaFond | 8884600185 | 89758 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H6874 - ASPIRUS HEALTH PLAN, INC. |
Aspirus, Inc. | Jennifer Pena | 8559314851 | 89802 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H1748 - SONDER HEALTH PLANS, INC. |
Avian Health Holdings, LLC | Charles Merritt | 4707652163 | 89753 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H1748 - SONDER HEALTH PLANS, INC. |
Avian Health Holdings, LLC | Charles Merritt | 4707652163 | 89856 * | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H2737 - HEALTH NEW ENGLAND, INC. |
Baystate Health, Inc. | Member Services | 8774433314 | 89756 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
S5584 - BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY |
Blue Cross Blue Shield of Michigan Mutual Ins. Co. | Johanna Judson | 8663091719 | 89814 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H3170 - SAPPHIRE EDGE, INC. |
Blue Cross Blue Shield of Nebraska | Ashley Trice | 4029827000 | 89783 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H1347 - PATRIUS HEALTH, INC. |
BlueCross BlueShield of Alabama | Jeff Corley | 8005176425 | 89781 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
S1030 - BCBS OF ALABAMA & UTIC INSURANCE COMPANY |
BlueCross BlueShield of Alabama | Jeff Corley | 8005176425 | 89813 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H3015 - SHARED HEALTH MISSISSIPPI, INC. |
BlueCross BlueShield of Tennessee | Customer Service | 8772583002 | 89757 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H9946 - SHARED HEALTH MISSISSIPPI, INC. |
BlueCross BlueShield of Tennessee | Customer Service | 8772583002 | 89810 * | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H2056 - AETNA BETTER HEALTH OF MICHIGAN INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 89754 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H5309 - AETNA HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 89762 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H3928 - AETNA HEALTH INC. (LA) |
CVS Health Corporation | Aetna Customer Service | 8335706670 | 89790 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H4711 - COVENTRY HEALTH CARE OF NEBRASKA, INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 89795 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H4982 - AETNA BETTER HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 89796 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5309 - AETNA HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 89797 * | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 89858 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON |
Centene Corporation | Website Inquiries | 8888889355 | 89745 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 89749 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H1395 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8662968731 | 89751 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 89752 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC |
Centene Corporation | Website Inquiries | 8888889355 | 89759 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H5398 - CENTENE VENTURE COMPANY KANSAS |
Centene Corporation | Provider Services | 8662968731 | 89763 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H5599 - NEW YORK QUALITY HEALTHCARE CORPORATION |
Centene Corporation | Fidelis Member Services | 8002471447 | 89765 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6550 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 89768 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
|
H6713 - WELLCARE OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 89770 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6815 - HEALTH NET HEALTH PLAN OF OREGON, INC. |
Centene Corporation | Provider Services | 8662968731 | 89772 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H7169 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 89775 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 89778 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON |
Community Health Plan of Washington | Customer Care | 8009420247 | 89744 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3777 - BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA |
CuraCor Solutions Corp. | Member Services | 8882969790 | 89788 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6832 - ALIGN SENIOR CARE MI, LLC |
Curana Health Holdings, LLC | Rocio Sindlinger | 8558550489 | 89801 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3407 - EL PASO FIRST HEALTH PLANS, INC. |
El Paso County Hospital District | Viridiana Garcia | 9152987198 | 89787 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 89742 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H0907 - WELLPOINT IOWA, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 89750 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4704 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 89761 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 89776 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4161 - BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 89791 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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S5966 - EMBLEMHEALTH PLAN, INC |
EmblemHealth, Inc. | Nicole Tirado | 8773447364 | 89817 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6379 - CLEAR SPRING HEALTH (CO), INC. |
Group 1001 | Tracie Wilcox-Lange | 8476968503 | 89767 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6672 - CLEAR SPRING HEALTH (GA), INC. |
Group 1001 | Tracie Wilcox-Lange | 8476968503 | 89769 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5454 - CLEAR SPRING HEALTH OF ILLINOIS, INC. |
Group 1001 | Tracie Wilcox-Lange | 8476968503 | 89799 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6672 - CLEAR SPRING HEALTH (GA), INC. |
Group 1001 | Tracie Wilcox-Lange | 8476968503 | 89800 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H7389 - HealthSpring Life & Health Insurance Company, Inc. |
Health Care Service Corporation | Mike Soltis | 6238063361 | 89748 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3251 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8778956448 | 89786 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H8634 - HEALTH CARE SERVICE CORPORATION |
Health Care Service Corporation | Customer Service | 8778956448 | 89805 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9706 - HCSC INSURANCE SERVICES COMPANY |
Health Care Service Corporation | Customer Service | 8778956448 | 89808 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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S5660 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
Health Care Service Corporation | Express Scripts-Medicare | 8665294917 | 89815 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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S5715 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
Health Care Service Corporation | Customer Service | 8778956448 | 89816 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
Health Care Service Corporation | Corey Robinson | 4239546977 | 89860 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H2237 - INDEPENDENT CARE HEALTH PLAN |
Humana Inc. | Lisa Richter | 8004486262 | 89755 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H0783 - HUMANA BENEFIT PLAN OF TEXAS, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 89780 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H2237 - INDEPENDENT CARE HEALTH PLAN |
Humana Inc. | Lisa Richter | 8004486262 | 89782 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. |
Humana Inc. | Lisa Richter | 8004486262 | 89806 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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R1532 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 89811 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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R7220 - HUMANA INSURANCE COMPANY |
Humana Inc. | Lisa Richter | 8004486262 | 89812 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5361 - AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY |
Independence Health Group, Inc. | Customer Service | 8006453965 | 89798 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9986 - HPMP OF FLORIDA, INC. |
Independent Living Systems, LLC | Abby Riddle | 8333227526 | 89779 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4232 - AMERICAN HEALTH PLAN OF UT, INC. |
Mitchell Family Office | Kari Voigtmann | 8555210627 | 89792 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9909 - AMERICAN HEALTH PLAN OF MS, INC. |
Mitchell Family Office | Kari Voigtmann | 8449170642 | 89809 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 89766 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5433 - ORANGE COUNTY HEALTH AUTHORITY |
Orange County Health Authority | Customer Service | 8774122734 | 89764 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3204 - PRESBYTERIAN HEALTH PLAN |
Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 89785 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9042 - SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC. |
SIHO Holding, Inc. | Michelle Jones | 8123787107 | 89807 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9153 - WEST VIRGINIA SENIOR ADVANTAGE, INC. |
SNP Holdings, LLC | Laura Risher | 8448546888 | 89777 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H3186 - SANFORD HEALTH PLAN OF MINNESOTA |
Sanford Health | Aleesa Jansick | 6053287182 | 89784 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4544 - PEOPLES HEALTH, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8773691907 | 89793 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY |
UnitedHealth Group, Inc. | UHC Customer Service | 8664608854 | 89861 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H7646 - UNIVERSITY OF MICHIGAN HEALTH MEDICARE |
University of Michigan Health | PHP CustomerService | 8445293757 | 89804 * | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H9066 - VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK |
VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | Amanda Frederick | 8884774663 | 89859 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89747 * | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4624 - ZING HEALTH OF MICHIGAN, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89760 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6876 - ZING HEALTH OF MICHIGAN, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89773 | 12-FEB-2026 | Health Benefit | Star Ratings | Contract earned less than three Stars for 1 year Part C Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H4624 - ZING HEALTH OF MICHIGAN, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89794 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H6876 - ZING HEALTH OF MICHIGAN, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89803 | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 89857 * | 12-FEB-2026 | Drug Benefit | Star Ratings | Contract earned less than three Stars for 2 years Part D Summary Ratings | Ad-Hoc CAP-letter.pdf |
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H5959 - BCBSM, Inc. |
Aware Integrated, Inc. | Patrick Cosgrove | 6516623727 | 89731 | 11-FEB-2026 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2026 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H2882 - PACE CENTRAL MICHIGAN, INC. |
PACE Central Michigan, Inc. | Lisa Minns | 9899535800 | 89351 | 23-JAN-2026 | Health Benefit | PACE-specific Issues | Failure to Meet Participant Needs Through Interdisciplinary Team Assessments and Provision of Specialty Services | Ad-Hoc CAP-letter.pdf |
|
H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 85665 * | 25-FEB-2025 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2022 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H7379 - CAREFIRST ADVANTAGE PPO, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 85666 | 25-FEB-2025 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2022 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 85667 | 25-FEB-2025 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2022 MLR data. | Ad-Hoc CAP-letter.pdf |
|
H1977 - UPPER PENINSULA HEALTH PLAN, LLC |
DLP Marquette General Hospital, LLC | Melanie Bicigo | 9062257749 | 85587 * | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H3407 - EL PASO FIRST HEALTH PLANS, INC. |
El Paso County Hospital District | Viridiana Garcia | 9152987198 | 85539 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | LEP 2024 CAP | Ad-Hoc CAP-letter.pdf |
|
H7220 - HealthKeepers, Inc. |
Elevance Health, Inc. | Customer Service | 8882307338 | 85540 | 25-FEB-2025 | Health and Drug Benefit | Accuracy & Accessibility Study | LEP 2024 CAP | Ad-Hoc CAP-letter.pdf |
|
H6988 - Anthem HP, LLC |
Elevance Health, Inc. | Yaritza Castillo | 8442745227 | 85598 | 25-FEB-2025 | Drug Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H2392 - KANSAS SUPERIOR SELECT, INC. |
Kansas Superior Select | Kari Voigtmann | 8003997524 | 85595 | 25-FEB-2025 | Health and Drug Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H3708 - OKLAHOMA SUPERIOR SELECT, INC. |
Mitchell Family Office | Kari Voigtmann | 8665834649 | 85588 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H4232 - AMERICAN HEALTH PLAN OF UT, INC. |
Mitchell Family Office | Kari Voigtmann | 8555210627 | 85590 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H4490 - AMERICAN HEALTH PLAN OF MISSOURI, INC. |
Mitchell Family Office | Kari Voigtmann | 8442287934 | 85591 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H6891 - AMERICAN HEALTH PLAN OF TX, INC. |
Mitchell Family Office | Kari Voigtmann | 8555210628 | 85592 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H7779 - AMERICAN HEALTH PLAN, INC. |
Mitchell Family Office | Kari Voigtmann | 8443211763 | 85593 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H9909 - AMERICAN HEALTH PLAN OF MS, INC. |
Mitchell Family Office | Kari Voigtmann | 8449170642 | 85594 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H6652 - AMERICAN HEALTH PLAN OF FL, INC. |
Mitchell Family Office | Kari Voigtmann | 8555210626 | 85596 | 25-FEB-2025 | Health and Drug Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H8093 - GEORGIA ASSURANCE, INC. |
Mitchell Family Office | Kari Voigtmann | 8449170645 | 85597 | 25-FEB-2025 | Health and Drug Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
H3811 - SAMARITAN HEALTH PLANS, INC. |
Samaritan Health Services, Inc. | Tom Loach | 2089956866 | 85589 | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | 2024 TTY CAP | Ad-Hoc CAP-letter.pdf |
|
S2668 - MEMBERS HEALTH INSURANCE COMPANY |
Tennessee Rural Health Improvement Association | Tracy Ring | 8339990135 | 85541 * | 25-FEB-2025 | Drug Benefit | Accuracy & Accessibility Study | LEP 2024 CAP | Ad-Hoc CAP-letter.pdf |
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | WHA Member Services | 8885632250 | 85538 * | 25-FEB-2025 | Health Benefit | Accuracy & Accessibility Study | LEP 2024 CAP | Ad-Hoc CAP-letter.pdf |
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | WHA Member Services | 8885632250 | 85599 * | 25-FEB-2025 | Health and Drug Benefit | Accuracy & Accessibility Study | 2024 TTY 2nd CAP | Ad-Hoc CAP-letter.pdf |
|
H3814 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 85260 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5995 - ATRIO HEALTH PLANS |
ATRIO Health Plans | Customer Service | 8776728620 | 85269 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5969 - ALOHACARE |
AlohaCare | AlohaCare Customer Service | 8089736395 | 85268 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1748 - SONDER HEALTH PLANS, INC. |
Avian Health Holdings, LLC | Charles Merritt | 4707652163 | 85279 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6851 - BOSTON MEDICAL CENTER HEALTH PLAN, INC. |
BMC Health System, Inc. | Sherri-Ann de Medeiros | 8885660008 | 85270 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5587 - HEALTH CHOICE ARIZONA, INC. |
Blue Cross Blue Shield of Arizona | Member Services | 8006568991 | 85263 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5953 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA |
BlueCross BlueShield of South Carolina (BCBSSC) | Provider Services | 8003342583 | 85308 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4982 - AETNA BETTER HEALTH OF CALIFORNIA INC. |
CVS Health Corporation | Aetna Customer Service | 8006240756 | 85274 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5601 - SILVERSCRIPT INSURANCE COMPANY |
CVS Health Corporation | Kelly Devine | 8662355660 | 85303 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4937 - CALIFORNIA PHYSICIANS' SERVICE |
California Physicians' Service | Member Services | 8007764466 | 85262 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5609 - ASURIS NORTHWEST HEALTH |
Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 85304 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8854 - CAREFIRST ADVANTAGE DSNP, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 85297 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2162 - WELLCARE OF NEW HAMPSHIRE, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85256 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2174 - TRILLIUM COMMUNITY HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 85257 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3561 - HEALTH NET COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 85259 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85265 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON |
Centene Corporation | Website Inquiries | 8888889355 | 85267 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Provider Services | 8662968731 | 85273 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85277 * | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9900 - WELLCARE OF OKLAHOMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85278 * | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2775 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY |
Centene Corporation | Website Inquiries | 8888889355 | 85286 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2853 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8662968731 | 85287 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3561 - HEALTH NET COMMUNITY SOLUTIONS, INC. |
Centene Corporation | Provider Services | 8662968731 | 85289 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7512 - CENTENE VENTURE COMPANY MICHIGAN |
Centene Corporation | Provider Services | 8662968731 | 85294 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2117 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85342 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9900 - WELLCARE OF OKLAHOMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 85346 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0571 - CHINESE COMMUNITY HEALTH PLAN |
Chinese Hospital Association | Ketan G | 6282283241 | 85251 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7607 - CLEVER CARE OF GOLDEN STATE, INC. |
Clever Care Health Plan, Inc. | Customer Service | 8333888168 | 85296 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2034 - COMMUNITY CARE HEALTH PLAN, INC. |
Community Care, Inc. | Provider Hotline | 8669372783 | 85282 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON |
Community Health Plan of Washington | Customer Care | 8009420247 | 85266 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2185 - LIFEWORKS ADVANTAGE, LLC |
Curana Health Holdings, LLC | Rocio Sindlinger | 8558550489 | 85284 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9888 - DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC |
Devoted Health, Inc. | Shannon O'Kane | 8003386833 | 85301 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three 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 | 85240 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H1894 - WELLPOINT WASHINGTON, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 85255 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3536 - MATTHEW THORNTON HEALTH PLAN, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 85288 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9469 - WELLPOINT LIFE AND HEALTH INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 85299 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5960 - WELLPOINT LIFE AND HEALTH INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 85309 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1302 - BLUE CROSS OF IDAHO HEALTH SERVICE, INC. |
Gemstone Holdings, Inc. | Customer Service | 2083958200 | 85254 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C 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 | 85306 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0034 - HAMASPIK, INC. |
Hamaspik of Rockland County, Inc. | David Friedman | 8455030901 | 85250 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0034 - HAMASPIK, INC. |
Hamaspik of Rockland County, Inc. | David Friedman | 8455030901 | 85341 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9826 - COMMUNITY HEALTH CHOICE TEXAS, INC. |
Harris County Hospital District | Michael Banda | 7133145667 | 85345 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4801 - GHS INSURANCE COMPANY |
Health Care Service Corporation | Customer Service | 8777748592 | 85343 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9678 - HEALTHFIRST INSURANCE COMPANY, INC. |
Healthfirst, Inc. | Provider Services | 8888011660 | 85300 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H3384 - Highmark Western and Northeastern New York Inc. |
Highmark Health | Customer Service | 8773271395 | 85241 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H3916 - HIGHMARK SENIOR HEALTH COMPANY |
Highmark Health | Provider Service | 8665886967 | 85242 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H5526 - Highmark Western and Northeastern New York Inc. |
Highmark Health | Customer Service | 8773271395 | 85243 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H0885 - HEALTHIER NEW JERSEY INSURANCE COMPANY |
Horizon Mutual Holdings, Inc | Suze Mestres | 9734665503 | 85244 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
S5552 - HUMANA INSURANCE COMPANY OF NEW YORK |
Humana Inc. | Lisa Richter | 8004486262 | 85302 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Clifton Schmidt | 8014427249 | 85245 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H1230 - KAISER FOUNDATION HP, INC. |
Kaiser Foundation Health Plan, Inc. | Member Services | 8004430815 | 85248 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H1224 - LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY |
Local Initiative Health Authority for LA County | Provider Service Unit | 8665222736 | 85253 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2722 - Primewell Health Services of Arkansas, Inc. |
Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 85258 * | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5580 - MERCY CARE |
Mercy Care | Shannon Richardson | 6024535592 | 85291 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6891 - AMERICAN HEALTH PLAN OF TX, INC. |
Mitchell Family Office | Kari Voigtmann | 8555210628 | 85344 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 85247 * | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 85264 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 85276 * | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 85292 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7559 - Molina Healthcare of Virginia, LLC |
Molina Healthcare, Inc. | Member Services | 8006650898 | 85295 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9047 - PROVIDENCE HEALTH ASSURANCE |
Providence St Joseph Health | Amy Ocheltree | 5035746098 | 85246 | 17-JAN-2025 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2025 Bid Instructions | Ad-Hoc CAP-letter.pdf |
|
H4093 - PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC |
Rifkin Managed Care Holding, LLC | Sue Radice | 4109913213 | 85280 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H4045 - SANTA CLARA COUNTY HEALTH AUTHORITY |
SANTA CLARA COUNTY HEALTH AUTHORITY | Customer Services | 8777234795 | 85261 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0672 - HEALTHSPRING HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 85252 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7389 - HealthSpring Life & Health Insurance Company, Inc. |
The Cigna Group | Mike Soltis | 6238063361 | 85271 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9460 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 85272 | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0672 - HEALTHSPRING HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 85281 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2752 - BRAVO HEALTH PENNSYLVANIA, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 85285 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H5410 - HEALTHSPRING OF FLORIDA, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 85290 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5617 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY |
The Cigna Group | Corey Robinson | 4239546977 | 85305 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7389 - HealthSpring Life & Health Insurance Company, Inc. |
The Cigna Group | Mike Soltis | 6238063361 | 85340 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY |
UnitedHealth Group, Inc. | UHC Customer Service | 8664608854 | 85307 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H9066 - VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK |
VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | Amanda Frederick | 8884774663 | 85298 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2168 - VILLAGE SENIOR SERVICES CORPORATION |
Village Care of New York, Inc. | Provider Services | 8557692500 | 85283 | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 85275 * | 17-JAN-2025 | Health Benefit | Star Ratings | Less than three Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7330 - ZING HEALTH, INC. |
Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 85293 * | 17-JAN-2025 | Drug Benefit | Star Ratings | Less than three Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0876 - Commonwealth Care Alliance Rhode Island, LLC H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. H2225 - COMMONWEALTH CARE ALLIANCE, INC. H9414 - Commonwealth Care Alliance Massachusetts, LLC. H9861 - CCA HEALTH MICHIGAN, INC. H9876 - Commonwealth Care Alliance Rhode Island, LLC |
Commonwealth Care Alliance, Inc. | Member Services | 8334209332, 8559595855, 8663333530, 8664209332 | 80197 | 31-OCT-2024 | Health and Drug Benefit | Marketing |
Commonwealth Care Alliance (CCA) CY 2024 failure to adhere to marketing and communication materials guidelines: On October 20, 2023 CCA notified their AM team that they had identified several inconsistencies in the benefit highlights sheets contained in the enrollment books. This led to a complete review of AEP materials including Summary of Benefits (SB) and Evidence of Coverage (EOC) for all contracts. Six out of seven CCA contracts H1426, H2225, H9414, H9861, H9876, and H0876 had errors in distributed CY 2024 materials. In total Benefit Highlight sheets had 51 errors. Sales/brokers were notified on October 20, 2023 to cease using the material and destroy the physical inventory and corrected the errors on November 17, 2023. SBs had 51 errors that were disclosed on October 24th and corrected on November 6 and 7th. EOCs had 48 errors that were disclosed in multiple revisions from November 9-24, 2023 followed by EOC errata submission on December 5th, 2023. The disclosures and accurate correction of the materials required multiple CMS AM inquiries and material denials leading to revised submissions in the HPMS marketing module. The organization has implemented a new marketing and communications review process which went into effect on October 20, 2023 when the plan discovered the inaccuracies. Member Impact: Prospective CY 2024-member enrollment for the affected contracts November 6, 2023 was 835 members. Potentially more prospective members were impacted by the EOC errors corrected by EOC errata mailed after December 5, 2023. |
Ad-Hoc CAP-letter.pdf |
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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 |
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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 |
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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 |
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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 |
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H2064 - GEISINGER COMMUNITY HEALTH SERVICES |
Risant Health, Inc. | Teena Kubasti | 5703732107 | 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 |
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H8492 - DIGNITY CARE CORPORATION |
Mitchell Family Office | Kari Voigtmann | 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 |
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H5945 - PROMINENCE HEALTHFIRST |
Universal Health Services, Inc. | Danielle Koltz | 7757709302 | 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 |
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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 |
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H1994 - SELECTHEALTH, INC. |
Intermountain Health Care, Inc. | Clifton Schmidt | 8014427249 | 80434 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
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H4286 - LEON HEALTH, INC. |
LMC Family Holdings, LLC | Provider Service | 1833373536 | 80430 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
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H3811 - SAMARITAN HEALTH PLANS, INC. |
Samaritan Health Services, Inc. | Tom Loach | 2089956866 | 80432 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
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H5410 - HEALTHSPRING OF FLORIDA, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 80433 | 18-JAN-2024 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2024 Bid Instructions | Ad-Hoc CAP-letter.pdf |
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S6506 - BLUE CROSS AND BLUE SHIELD ARIZONA, INC. |
Blue Cross Blue Shield of Arizona | Member Services | 4809370409 | 80193 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9147 - BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA |
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 |
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H9147 - BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA |
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 |
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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 |
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H0838 - UNIVERSAL CARE, INC. |
Bright Health Group, Inc. | Member Services | 8006650898 | 80120 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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S8067 - Avalon Insurance Company |
CAPITAL BLUE CROSS | Melissa Leedock | 8666882242 | 80196 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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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 |
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H6399 - AETNA BETTER HEALTH INC. (NJ) |
CVS Health Corporation | Hollie Tanzillo | 6145727033 | 80005 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 80003 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6067 - CAREFIRST ADVANTAGE, INC. |
CareFirst, Inc. | Member Services | 8552905744 | 80151 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79968 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Provider Services | 8662968731 | 79974 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE |
Centene Corporation | Website Inquiries | 8888889355 | 79975 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79979 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1395 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8662968731 | 79980 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1664 - HOME STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 79981 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79984 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H2128 - CELTIC INSURANCE COMPANY |
Centene Corporation | Provider Services | 8662968731 | 79986 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H2853 - CENTENE VENTURE COMPANY TENNESSEE |
Centene Corporation | Provider Services | 8662968731 | 79989 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79991 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | Provider Services | 8662968731 | 79994 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H5439 - HEALTH NET LIFE INSURANCE COMPANY |
Centene Corporation | Provider Services | 8662968731 | 79997 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 79998 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6348 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8662968731 | 80004 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6446 - SILVERSUMMIT HEALTHPLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80006 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6605 - WELLCARE HEALTH INSURANCE OF HAWAII, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80007 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6678 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | Provider Services | 8662968731 | 80008 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80010 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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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 |
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H7399 - CENTENE VENTURE COMPANY ILLINOIS |
Centene Corporation | Provider Services | 8662968731 | 80013 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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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 |
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H8225 - CENTENE VENTURE COMPANY FLORIDA |
Centene Corporation | Provider Services | 8662968731 | 80018 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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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 |
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H9357 - CENTENE VENTURE INSURANCE COMPANY TEXAS |
Centene Corporation | Provider Services | 8662968731 | 80025 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80026 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80027 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9761 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80028 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9811 - MAGNOLIA HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80029 | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H9976 - WESTERN SKY COMMUNITY CARE, INC. |
Centene Corporation | Provider Services | 8662968731 | 80031 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80117 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. |
Centene Corporation | Provider Services | 8662968731 | 80119 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H1215 - NEBRASKA TOTAL CARE, INC. |
Centene Corporation | Provider Services | 8662968731 | 80122 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1353 - WELLCARE OF WASHINGTON, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80123 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H1848 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80126 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H2128 - CELTIC INSURANCE COMPANY |
Centene Corporation | Provider Services | 8662968731 | 80128 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80139 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H4343 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80142 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. |
Centene Corporation | Provider Services | 8662968731 | 80146 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON |
Centene Corporation | Website Inquiries | 8888889355 | 80150 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6193 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80152 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6348 - COORDINATED CARE CORPORATION |
Centene Corporation | Provider Services | 8662968731 | 80153 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H6975 - WELLCARE OF ALABAMA, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 80158 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
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H8225 - CENTENE VENTURE COMPANY FLORIDA |
Centene Corporation | Provider Services | 8662968731 | 80171 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9387 - SUNFLOWER STATE HEALTH PLAN, INC. |
Centene Corporation | Provider Services | 8662968731 | 80177 | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. |
Centene Corporation | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 80181 * | 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 | Provider Services | 8662968731 | 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 Clapper | 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 | Kari Voigtmann | 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 |
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H1732 - ANTHEM HP, LLC |
Elevance Health, Inc. | Customer Service | 8882307338 | 79982 * | 28-DEC-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
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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 |
|
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 | Rocio Sidlinger | 8558550489 | 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 | Tracie Wilcox-Lange | 8476968503 | 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 | Tracie Wilcox-Lange | 8476968503 | 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 | Elizabeth Cuevas | 7542085880 | 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. | David Friedman | 8455030901 | 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 | Michael Banda | 7133145667 | 80183 | 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 | 8777748592 | 80148 * | 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. | Lisa Richter | 8004486262 | 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. | Lisa Richter | 8004486262 | 80190 * | 28-DEC-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D 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. | James Davis | 4438849082 | 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 |
|
H7163 - Primewell Health Services of Mississippi Inc. |
Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 80160 * | 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 | Kari Voigtmann | 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 | Kari Voigtmann | 8555210628 | 80157 | 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 |
|
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 |
|
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. |
Molina Healthcare, Inc. | Member Services | 8006650898 | 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 |
|
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 | Customer Service | 8558646797 | 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 | PCSC Provider Care Unit | 5059235757 | 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 |
|
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 |
|
H7389 - HealthSpring Life & Health Insurance Company, Inc. |
The Cigna Group | Mike Soltis | 6238063361 | 80162 | 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. | Customer Service | 8884948769 | 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. | Customer Service | 8884948769 | 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 | 8004578506 | 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. | UHC Customer Service | 8448559776 | 80140 * | 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 | Tracie Wilcox-Lange | 8476968503 | 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 | 8559314851 | 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. | Brisa Dominguez | 6233992229 | 79298 * | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | Dan O'Donnell | 9167599401 | 79124 * | 25-OCT-2023 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
H4676 - TROY HEALTH, INC. |
Troy Holdings, Inc. | Customer Service | 8884948769 | 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 | Ben Tonga | 8012130161 | 79126 * | 25-OCT-2023 | Health Benefit | Accuracy & Accessibility Study | LEP CAP 2023 | Ad-Hoc CAP-letter.pdf |
|
H2782 - WESTERN HEALTH ADVANTAGE |
Western Health Advantage | WHA Member Services | 8885632250 | 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. | Bright Health | 8442024463 | 77830 * | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf |
|
H6988 - Anthem HP, LLC |
Centers Plan for Healthy Living, LLC | Yaritza Castillo | 8442745227 | 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 - BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA |
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. | James Davis | 4438849082 | 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 | Camille Trunkett | 3129692073 | 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 - UNIVERSITY OF MICHIGAN HEALTH 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 | Hollie Tanzillo | 6145727033 | 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 | Aetna Customer Service | 8006240756 | 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 | 8005216007 | 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 | WHA Member Services | 8885632250 | 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 | Member Services | 4809370409 | 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 | Hollie Tanzillo | 6145727033 | 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. | Member Services | 8552905744 | 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 | 8552905744 | 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 | 8662968731 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | 8662968731 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 - WELLPOINT INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 75206 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H8343 - WELLPOINT INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 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. | Customer Service | 8882307338 | 75234 * | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
S8182 - WELLPOINT INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 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. | Lisa Richter | 8004486262 | 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 | Customer Service | 8665087145 | 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. | Member Services | 8006650898 | 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. | Member Services | 8006650898 | 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 | Customer Service | 8558646797 | 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. | Brisa Dominguez | 6233992229 | 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 | Dan O'Donnell | 9167599401 | 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. | UHC Customer Service | 8665798774 | 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 | Garfield Collins | 8669464458 | 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. | Member Services | 8006650898 | 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. | Bright Health | 8442024463 | 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 | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | Provider Services | 8662968731 | 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 | Provider Services | 8662968731 | 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 | 8662968731 | 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 | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | 8662968731 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | Website Inquiries | 8888889355 | 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 | Provider Services | 8662968731 | 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 | 8662968731 | 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. | Customer Service | 8882307338 | 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 - WELLPOINT INSURANCE COMPANY |
Elevance Health, Inc. | Customer Service | 8882307338 | 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. | Customer Service | 8882307338 | 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. | Member Services | 8006650898 | 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. | Member Services | 8006650898 | 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 | Tracie Wilcox-Lange | 8476968503 | 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. | Member Services | 8006650898 | 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. | Member Services | 8006650898 | 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 | Suze Mestres | 9734665503 | 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 | PCSC Provider Care Unit | 5059235757 | 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 | Dan O'Donnell | 9167599401 | 75394 * | 22-FEB-2023 | Drug Benefit | OMS | Failure to comply with the Part D DMP access limitation requirements | Ad-Hoc CAP-letter.pdf |
|
H0672 - HEALTHSPRING HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 75121 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0439 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 75164 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H0672 - HEALTHSPRING HEALTHCARE OF COLORADO, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 75167 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H2108 - BRAVO HEALTH MID-ATLANTIC, INC. |
The Cigna Group | Mike Soltis | 6238063361 | 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. | Mark Britton | 9529126668 | 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. | Mark Britton | 9529126668 | 75141 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H6526 - UNITEDHEALTHCARE OF NEW MEXICO, INC. |
UnitedHealth Group, Inc. | UHC Customer Service | 8665798774 | 75151 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H7445 - UNITEDHEALTHCARE OF WISCONSIN, INC. |
UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 75156 * | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1375 - UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC |
UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 75173 * | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf |
|
H1924 - LASSO HEALTHCARE INSURANCE COMPANY |
Zing Health Consolidator, Inc | Provider Services | 8005790254 | 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 HP, LLC. H9525 - COMPCARE HEALTH SERVICES INSURANCE CORPORATION H9886 - HMO MISSOURI, INC. R5941 - ANTHEM INSURANCE COMPANIES, INC. |
Elevance Health, Inc. | Customer Service, Dedicated Services Unit | 8662894250, 8668054589, 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. | Nicole Tirado | 8773447364 | 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 | 8559314851 | 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. | Sara Foemmel | 7152219950 | 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 | shaun Smith | 5705223889 | 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 |
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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 |
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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 | 8662968731 | 72768 * | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
H8786 - WEllPOINT TEXAS, INC. |
Elevance Health, Inc. | Customer Service | 8882307338 | 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 | Barbra Mukuka | 7184845032 | 72770 * | 26-OCT-2022 | Health Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf |
|
S7694 - ELIXIR INSURANCE COMPANY |
Rite Aid Corporation | Dan O'Donnell | 9167599401 | 72767 * | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2022 | Ad-Hoc CAP-letter.pdf |
| Report Created: 5/1/2026 | 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 | |||||||||