### Ad-Hoc CAP Summary Report - October 2023
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
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
H9306 - ALTERWOOD ADVANTAGE, INC. | Alterwood Health, Inc. | David Margolit | 6672629412 | 77826 | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf
H4853 - BRIGHT HEALTH COMPANY OF ARIZONA | Bright Health Group, Inc. |  |  | 77830 * | 14-JUL-2023 | Health Benefit | Provider Directory | Failure to maintain accurate online provider directory | Ad-Hoc CAP-letter.pdf
H6988 - CENTERS PLAN FOR HEALTHY LIVING, LLC | Centers Plan for Healthy Living, LLC | Natalie Fernandes | 7182157000 | 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 - EXPERIENCE HEALTH, INC. | 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
H2678 - MoreCare, Inc. | MHNU Corporation |  |  | 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 - PHP 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 | Anne Marie Brown | 7272720427 | 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 | 8005330367 | 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 | 8669014692 | 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 | 8667844916 | 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 | 8667844918 | 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 |  |  | 76932 * | 20-JUN-2023 | Health and Drug Benefit | Reporting Requirements | Failure to report accurate CY2020 MLR data. | Ad-Hoc CAP-letter.pdf
H5945 - PROMINENCE HEALTHFIRST | Universal Health Services, Inc. | Libby Belli | 7757709450 | 76950 | 15-JUN-2023 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to be licensed in the State of Florida | H5945_Prominence_CAP.pdf
H4739 - SELECT HEALTH OF SOUTH CAROLINA, INC. | Independence Health Group, Inc. | Provider Services | 8889780862 | 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 | Stacy Weideman | 6028644391 | 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 | Anne Marie Brown | 7272720427 | 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 | 8443866762 | 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 | 8557661541 | 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 | 8555659519 | 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 | Provider Services | 8662968731 | 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 | Provider Services | 8662968731 | 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 | 8557661572 | 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 | Provider Services | 8662968731 | 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 | 8555659519 | 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 | Provider Services | 8662968731 | 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 | Provider Services | 8662968731 | 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 | 8665498289 | 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 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | Elevance Health, Inc. |  |  | 75206 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8343 - AMERIGROUP INSURANCE COMPANY | Elevance Health, Inc. |  |  | 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. |  |  | 75234 | 24-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S8182 - AMERIGROUP INSURANCE COMPANY | Elevance Health, Inc. |  |  | 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 | Amy Trichel | 8888231910 | 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., |  |  | 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., |  |  | 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. |  |  | 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 | Customer Service | 8662502005 | 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. | Mark Britton | 9529126668 | 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. | Bright Health | 8442024463 | 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. |  |  | 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 | 8009777522 | 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 | Health Net | 8008676564 | 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 | Member Services | 8557661452 | 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 | 8557661572 | 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 | 8667960530 | 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 | Provider Services | 8662968731 | 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 | Provider Services | 8662968731 | 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 | 8665498289 | 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 | Provider Services | 8662968731 | 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 | 8002754737 | 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 | Member Services | 8663897690 | 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 | Health Net | 8008676564 | 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 | 8555659519 | 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 - HEALTHPLUS 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 - AMERIGROUP 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 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | Elevance Health, Inc. |  |  | 75148 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1732 - HEALTHPLUS 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 - AMERIGROUP 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. | Priyank Pandey | 6464477543 | 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. | Priyank Pandey | 6464477543 | 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 | Elizabeth Cuevas | 7542085880 | 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., |  |  | 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 | 8553155663 | 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 |  |  | 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 | Customer Service | 8662502005 | 75394 | 22-FEB-2023 | Drug Benefit | OMS | Failure to comply with the Part D DMP access limitation requirements | Ad-Hoc CAP-letter.pdf
H0672 - CIGNA HEALTHCARE OF COLORADO, INC. | The Cigna Group | Jared Rich | 8006683813 | 75121 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. | The Cigna Group | Jared Rich | 8006683813 | 75164 | 22-FEB-2023 | Drug Benefit | Star Ratings | Less than three (3) Part D Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0672 - CIGNA HEALTHCARE OF COLORADO, INC. | The Cigna Group | Jared Rich | 8006683813 | 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 | Jared Rich | 8006683813 | 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. |  |  | 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. |  |  | 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. | Mark Britton | 9529126668 | 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. |  |  | 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. |  |  | 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 |  |  | 75131 | 22-FEB-2023 | Health Benefit | Star Ratings | Less than three (3) Part C Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2593 - AMERIGROUP TEXAS, INC. H3240 - AMERIGROUP 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 - EMPIRE HEALTHCHOICE HMO, INC. H9525 - COMPCARE HEALTH SERVICES INSURANCE CORPORATION H9886 - HMO MISSOURI, INC. R5941 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 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. | 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. | Priyank Pandey | 6464477543 | 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 | Pakou Vang | 6126763585 | 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. | Ken Baur | 7152219556 | 73871 | 11-JAN-2023 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY 2023 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H2537 - SPIRITRUST LUTHERAN LIFE | SpiritTrust Lutheran | LouAnn Shively | 5705223880 | 73227 | 01-DEC-2022 | Health Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to Maintain Fiscal Soundness | H2537 - SpiriTrust Lutheran LIFE_ CAP Continuation_12-01-2022.pdf
H2506 - Aetna Better Health Premier Plan MMAI Inc. | CVS Health Corporation | Anne Marie Brown | 7272720427 | 72769 | 26-OCT-2022 | Health and Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf
H8026 - AETNA BETTER HEALTH OF MICHIGAN INC. | CVS Health Corporation | Anne Marie Brown | 7272720427 | 72771 | 26-OCT-2022 | Health and Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf
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 | 8664336041 | 72768 | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf
H8786 - AMERIGROUP 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 |  |  | 72770 | 26-OCT-2022 | Health Benefit | Accuracy & Accessibility Study | TTY CAP 2022 | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 72767 | 26-OCT-2022 | Drug Benefit | Accuracy & Accessibility Study | LEP CAP 2022 | Ad-Hoc CAP-letter.pdf
H9877 - VIRGINIA PREMIER HEALTH PLAN, INC. | Sentara Health Care (SHC) |  |  | 70347 | 30-JUN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2019 and CY 2020 reporting year. | Ad-Hoc CAP-letter.pdf
H9955 - MOLINA HEALTHCARE OF OHIO, INC. | Molina Healthcare, Inc., | Member Services | 8664724584 | 68445 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., |  |  | 68444 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8845 - MOLINA HEALTHCARE OF ARIZONA, INC. | Molina Healthcare, Inc., | Member Services | 8006650898 | 68443 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8677 - MOLINA HEALTHCARE OF CALIFORNIA | Molina Healthcare, Inc., |  |  | 68442 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8423 - Molina Healthcare of Texas, Inc. | Molina Healthcare, Inc., |  |  | 68441 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8197 - MOLINA HEALTHCARE OF TEXAS, INC. | Molina Healthcare, Inc., | Member Services | 8668568699 | 68440 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8176 - MOLINA HEALTHCARE OF SOUTH CAROLINA,INC | Molina Healthcare, Inc., | Member Services | 8445263195 | 68439 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. | Molina Healthcare, Inc., |  |  | 68438 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8046 - MOLINA HEALTHCARE OF ILLINOIS, INC. | Molina Healthcare, Inc., | Member Services | 8779018181 | 68437 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7844 - MOLINA HEALTHCARE OF MICHIGAN, INC. | Molina Healthcare, Inc., | Member Services | 8557355604 | 68436 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. | Molina Healthcare, Inc., | Member Services | 8664400012 | 68435 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7559 - Molina Healthcare of Virginia, LLC | Molina Healthcare, Inc., | Member Services | 8006650898 | 68434 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5992 - SENIOR WHOLE HEALTH OF NEW YORK, INC. | Molina Healthcare, Inc., | Member Services | 8006650898 | 68433 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. | Molina Healthcare, Inc., | Member Services | 8006653072 | 68432 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. | Molina Healthcare, Inc., | Member Services | 8006651029 | 68431 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5810 - MOLINA HEALTHCARE OF CALIFORNIA | Molina Healthcare, Inc., | Member Services | 8006650898 | 68430 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5628 - MOLINA HEALTHCARE OF UTAH, INC. | Molina Healthcare, Inc., | Member Services | 8886651328 | 68429 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5280 - MOLINA HEALTHCARE OF OHIO, INC. | Molina Healthcare, Inc., | Member Services | 8556654623 | 68428 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. | Molina Healthcare, Inc., | Member Services | 8553155663 | 68427 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2533 - MOLINA HEALTHCARE OF SOUTH CAROLINA, INC. | Molina Healthcare, Inc., | Member Services | 8557355831 | 68426 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2224 - SENIOR WHOLE HEALTH, LLC | Molina Healthcare, Inc., | Member Services | 8006650898 | 68425 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1799 - MOLINA HEALTHCARE OF KENTUCKY, INC. | Molina Healthcare, Inc., | Member Services | 8006650898 | 68424 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
S4802 - WELLCARE PRESCRIPTION INSURANCE, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68554 | 26-MAY-2022 | Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9976 - WESTERN SKY COMMUNITY CARE, INC. | Centene Corporation | Provider Services | 8662968731 | 68553 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9900 - WELLCARE OF OKLAHOMA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68552 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9811 - MAGNOLIA HEALTH PLAN, INC. | Centene Corporation | Member Services | 8779358023 | 68551 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9761 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68550 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC | Centene Corporation | Website Inquiries | 8888889355 | 68549 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9630 - ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC | Centene Corporation | Provider Services | 8555659518 | 68548 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9428 - WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68547 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9387 - SUNFLOWER STATE HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8555659519 | 68546 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9364 - WELLCARE OF MAINE, INC. | Centene Corporation | Provider Services | 8555659519 | 68545 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9357 - CENTENE VENTURE INSURANCE COMPANY TEXAS | Centene Corporation | Provider Services | 8555659519 | 68544 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9335 - WELLCARE HEALTH PLANS OF MISSOURI, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68543 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9276 - SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC. | Centene Corporation | Provider Services | 8667960530 | 68542 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H9258 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68541 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8711 - WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY | Centene Corporation | Website Inquiries | 8888889355 | 68540 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8553 - WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68539 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8458 - SILVERSUMMIT HEALTHPLAN, INC. | Centene Corporation | Provider Services | 8665498289 | 68538 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8225 - CENTENE VENTURE COMPANY FLORIDA | Centene Corporation | Provider Services | 8667960530 | 68537 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. | Centene Corporation | Provider Services | 8002229831 | 68536 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H8121 - CENTENE VENTURE COMPANY TENNESSEE | Centene Corporation | Provider Services | 8667960530 | 68535 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7925 - CENTENE VENTURE COMPANY INDIANA, INC. | Centene Corporation | Provider Services | 8662968731 | 68534 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7556 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. | Centene Corporation |  |  | 68533 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7518 - WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC | Centene Corporation | Website Inquiries | 8888889355 | 68532 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7512 - CENTENE VENTURE COMPANY MICHIGAN | Centene Corporation | Provider Services | 8662968731 | 68531 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7399 - CENTENE VENTURE COMPANY ILLINOIS | Centene Corporation | Provider Services | 8662968731 | 68530 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7360 - HEALTH NET OF CALIFORNIA, INC. | Centene Corporation | Provider Services | 8002754737 | 68529 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7326 - WELLCARE OF SOUTH CAROLINA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68528 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7323 - WELLCARE NATIONAL HEALTH INSURANCE COMPANY | Centene Corporation | Website Inquiries | 8888889355 | 68527 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68526 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7173 - PEACH STATE HEALTH PLAN, INC. | Centene Corporation |  |  | 68525 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H7169 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC. | Centene Corporation | Provider Services | 8662968731 | 68524 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6975 - WELLCARE OF ALABAMA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68523 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6870 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Provider Services | 8773915921 | 68522 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6830 - CENTENE VENTURE COMPANY KANSAS | Centene Corporation | Provider Services | 8555659519 | 68521 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6815 - HEALTH NET HEALTH PLAN OF OREGON, INC. | Centene Corporation | Provider Services | 8884458913 | 68520 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6713 - WELLCARE OF ILLINOIS, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68519 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6678 - CENTENE VENTURE INSURANCE COMPANY TEXAS | Centene Corporation | Provider Services | 8555659519 | 68518 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6605 - WELLCARE HEALTH INSURANCE OF HAWAII, INC. | Centene Corporation | Provider Services | 8662968731 | 68517 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6594 - WELLCARE HEALTH PLANS OF VERMONT, INC. | Centene Corporation | Provider Services | 8662968731 | 68516 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6550 - SUNFLOWER STATE HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8555659519 | 68515 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6446 - SILVERSUMMIT HEALTHPLAN, INC. | Centene Corporation | Provider Services | 8665498289 | 68514 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6348 - COORDINATED CARE CORPORATION | Centene Corporation | Provider Services | 8557661541 | 68513 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6193 - WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC. | Centene Corporation | Provider Services | 8662968731 | 68512 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H6080 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. | Centene Corporation | Member Services | 8553234578 | 68511 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5965 - WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON | Centene Corporation | Provider Services | 8662968731 | 68510 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. | Centene Corporation | Provider Services | 8662968731 | 68509 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5599 - NEW YORK QUALITY HEALTHCARE CORPORATION | Centene Corporation | Fidelis Member Services | 8002471447 | 68508 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5590 - Bridgeway Health Solutions of Arizona, Inc. | Centene Corporation | Provider Services | 8773915921 | 68507 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Centene Corporation | Provider Services | 8662968731 | 68506 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5439 - HEALTH NET LIFE INSURANCE COMPANY | Centene Corporation | Provider Services | 8002754737 | 68505 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5430 - ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC. | Centene Corporation | Provider Services | 8662968731 | 68504 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5398 - CENTENE VENTURE COMPANY KANSAS | Centene Corporation | Provider Services | 8555659519 | 68503 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5294 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Member Services | 8779358023 | 68502 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | Centene Corporation | Provider Services | 8662968731 | 68501 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5190 - SUNSHINE STATE HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8667960530 | 68500 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5117 - LOUISIANA HEALTHCARE CONNECTIONS, INC. | Centene Corporation | Provider Services | 8557661572 | 68499 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H5087 - WELLCARE OF CALIFORNIA, INC. | Centene Corporation | Provider Services | 8662968731 | 68498 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4868 - NEW YORK QUALITY HEALTHCARE CORPORATION | Centene Corporation | Provider Services | 8662968731 | 68497 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4847 - WELLCARE OF SOUTH CAROLINA, INC. | Centene Corporation | Provider Services | 8662968731 | 68496 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4699 - WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. | Centene Corporation | Provider Services | 8662968731 | 68495 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4537 - WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC. | Centene Corporation | Provider Services | 8662968731 | 68494 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4506 - SELECTCARE OF TEXAS, INC. | Centene Corporation | Provider Services | 8662968731 | 68493 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4343 - CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8555659519 | 68492 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H4073 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. | Centene Corporation | Provider Services | 8662968731 | 68491 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H3975 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC | Centene Corporation | Website Inquiries | 8888889355 | 68490 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H3561 - HEALTH NET COMMUNITY SOLUTIONS, INC. | Centene Corporation | Provider Services | 8002754737 | 68489 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H3499 - COORDINATED CARE CORPORATION | Centene Corporation | Provider Services | 8557661541 | 68488 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H3237 - HEALTH NET COMMUNITY SOLUTIONS, INC. | Centene Corporation |  |  | 68487 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H3047 - WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA | Centene Corporation | Website Inquiries | 8888889355 | 68486 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2915 - PENNSYLVANIA HEALTH & WELLNESS, INC. | Centene Corporation | Member Services | 8557661452 | 68485 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2853 - CENTENE VENTURE COMPANY TENNESSEE | Centene Corporation | Provider Services | 8555659519 | 68484 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2816 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY | Centene Corporation | Website Inquiries | 8888889355 | 68483 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2775 - AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY | Centene Corporation | Website Inquiries | 8888889355 | 68482 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68481 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2174 - TRILLIUM COMMUNITY HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8448671156 | 68480 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2162 - WELLCARE OF NEW HAMPSHIRE, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68479 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2134 - WESTERN SKY COMMUNITY CARE, INC. | Centene Corporation | Provider Services | 8662968731 | 68478 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2128 - CELTIC INSURANCE COMPANY | Centene Corporation | Member Services | 8557661452 | 68477 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2117 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68476 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68475 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1862 - WELLCARE HEALTH PLANS OF VERMONT, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68474 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1848 - WELLCARE OF ALABAMA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68473 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1774 - CENTENE VENTURE COMPANY INDIANA, INC. | Centene Corporation | Provider Services | 8662968731 | 68472 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1723 - ABSOLUTE TOTAL CARE, INC. | Centene Corporation | Provider Services | 8664336041 | 68471 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1664 - HOME STATE HEALTH PLAN, INC. | Centene Corporation | Health Net | 8008676564 | 68470 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1436 - ABSOLUTE TOTAL CARE, INC. | Centene Corporation |  |  | 68469 * | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1416 - HARMONY HEALTH PLAN, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68468 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1395 - NEBRASKA TOTAL CARE, INC. | Centene Corporation | Provider Services | 8667960530 | 68467 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1353 - WELLCARE OF WASHINGTON, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68466 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1215 - NEBRASKA TOTAL CARE, INC. | Centene Corporation | Health Net | 8008676564 | 68465 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1112 - WELLCARE OF GEORGIA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68464 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H1032 - Sunshine State Health Plan, Inc. | Centene Corporation | Website Inquiries | 8888889355 | 68463 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0969 - WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE | Centene Corporation | Website Inquiries | 8888889355 | 68462 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68461 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8662968731 | 68460 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. | Centene Corporation | Member Services | 8663897690 | 68459 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0712 - WELLCARE OF CONNECTICUT, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68458 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0562 - HEALTH NET OF CALIFORNIA, INC. | Centene Corporation | Provider Services | 8002754737 | 68457 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0482 - CENTENE VENTURE COMPANY MICHIGAN | Centene Corporation | Provider Services | 8662968731 | 68456 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0480 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Centene Corporation | Member Services | 8553234578 | 68455 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0351 - HEALTH NET OF ARIZONA, INC. | Centene Corporation | Provider Services | 8009777522 | 68454 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0270 - WELLCARE HEALTH INSURANCE COMPANY OF AMERICA | Centene Corporation | Website Inquiries | 8888889355 | 68453 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0174 - WELLCARE OF TEXAS, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68452 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0111 - WELLCARE OF GEORGIA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68451 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0088 - WELLCARE HEALTH INSURANCE OF NEW YORK, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68450 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0074 - WELLCARE OF MISSISSIPPI, INC. | Centene Corporation | Website Inquiries | 8888889355 | 68449 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0062 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Member Services | 8779358023 | 68448 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0029 - COORDINATED CARE OF WASHINGTON, INC. | Centene Corporation | Health Net | 8008676564 | 68447 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H0022 - BUCKEYE COMMUNITY HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8662968731 | 68446 | 26-MAY-2022 | Health and Drug Benefit | Oversight and Management Capabilities | Failure to provide compliant call center services | Ad-Hoc CAP-letter.pdf
H2537 - SPIRITRUST LUTHERAN LIFE | SpiritTrust Lutheran | LouAnn Shively | 5705223880 | 68113 | 29-APR-2022 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain fiscal soundness | H2537 CAP.pdf
H0839 - VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC | Volunteers of America National Services | Antionette Hively | 9194253000 | 68112 | 29-APR-2022 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain fiscal soundness | H0839 CAP.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 67969 | 01-APR-2022 | Drug Benefit | OMS | Failure to comply with the Part D DMP coverage limitation requirements | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 67968 | 01-APR-2022 | Drug Benefit | OMS | Failure to disclose data to CMS in accordance with Part D DMP requirements | Ad-Hoc CAP-letter.pdf
H3362 - INDEPENDENT HEALTH ASSOCIATION, INC. | Independent Health Association, Inc. | Member Services | 8006651502 | 67653 | 04-MAR-2022 | Drug Benefit | Benefit Administration | Failure to Administer CY 2022 Benefit as Approved | Ad-Hoc CAP-letter.pdf
H3344 - INDEPENDENT HEALTH BENEFITS CORPORATION | Independent Health Association, Inc. | Member Services | 8006651502 | 67652 | 04-MAR-2022 | Drug Benefit | Benefit Administration | Failure to Administer CY 2022 Benefit as Approved | Ad-Hoc CAP-letter.pdf
H8280 - BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. H8364 - BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. | Bright Health Group, Inc. |  |  | 67847 * | 02-MAR-2022 | Health and Drug Benefit | Other | BHIC failed to adhere to CMS' change of ownership requirements and did not ensure that BHIC was approved to operate in all service areas. | CAP_H8280 H8364.pdf
H9706 - HCSC INSURANCE SERVICES COMPANY | Health Care Service Corporation | Customer Service | 8778956448 | 67649 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9589 - CLEAR SPRING HEALTH (GA), INC. | Group 1001 | Elizabeth Cuevas | 7542085880 | 67648 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7330 - ZING HEALTH, INC. | Zing Health Consolidator, Inc | Garfield Collins | 8669464458 | 67647 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6446 - SILVERSUMMIT HEALTHPLAN, INC. | Centene Corporation | Provider Services | 8665498289 | 67646 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5015 - TEXAS INDEPENDENCE HEALTH PLAN, INC. | Regency ISNP Holdings LLC | Customer Service | 8559695907 | 67645 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2793 - IMPERIAL INSURANCE COMPANIES INC. | Imperial Health Plan of California |  |  | 67644 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2678 - MoreCare, Inc. | MHNU Corporation |  |  | 67643 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1947 - COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 67642 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S8182 - AMERIGROUP INSURANCE COMPANY | Elevance Health, Inc. |  |  | 67641 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S6946 - CLEAR SPRING HEALTH INSURANCE COMPANY | Group 1001 | Elizabeth Cuevas | 7542085880 | 67640 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8293 - CLEAR SPRING HEALTH (VA), INC. | Group 1001 | Elizabeth Cuevas | 7542085880 | 67639 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6379 - CLEAR SPRING HEALTH (CO), INC. | Group 1001 | Elizabeth Cuevas | 7542085880 | 67638 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7322 - OSCAR HEALTH PLAN OF NEW YORK, INC. | Oscar Health, Inc. |  |  | 67637 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7175 - WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 67636 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5496 - IMPERIAL HEALTH PLAN OF CALIFORNIA, INC. | Imperial Health Plan of California | Erica Ruiz | 8007087903 | 67635 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5199 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | Centene Corporation | Provider Services | 8662968731 | 67634 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1924 - LASSO HEALTHCARE INSURANCE COMPANY | Port Holdings, Inc. |  |  | 67633 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1914 - WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. | Centene Corporation | Website Inquiries | 8888889355 | 67632 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0724 - BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. | Centene Corporation | Member Services | 8663897690 | 67631 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S7126 - OMAHA HEALTH INSURANCE COMPANY | Mutual of Omaha Insurance Company | Customer Service | 8558646797 | 67630 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S5609 - ASURIS NORTHWEST HEALTH | Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 67629 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S3285 - MG INSURANCE COMPANY | MedImpact Holdings, Inc. | Customer Service | 8448263451 | 67628 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S1894 - COMMUNITYCARE GOVERNMENT PROGRAMS, INC. | St Francis Health System & St John Health System |  |  | 67627 * | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8764 - ASPIRE HEALTH PLAN | Montage Health | Customer Service | 8555701600 | 67626 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8554 - GHS INSURANCE COMPANY | Health Care Service Corporation | Customer Service | 8778956448 | 67625 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5273 - CAREPARTNERS OF CONNECTICUT, INC. | Point32Health, Inc. | Kenneth Kayser | 7816121000 | 67624 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4093 - PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | Rifkin Managed Care Holding, LLC | Sue Radice | 4109913213 | 67623 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. | Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 67622 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2793 - IMPERIAL INSURANCE COMPANIES INC. | Imperial Health Plan of California |  |  | 67621 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2400 - SIGNATURE ADVANTAGE, LLC | SA Plan, LLC | Shawna Hearing | 8442148633 | 67620 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1189 - CHRISTUS HEALTH PLAN | CHRISTUS Health | Ronda Hefton | 8442823026 | 67619 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0982 - SOLIS HEALTH PLANS, INC. | Athena Healthcare Holdings, LLC | Provider Services | 8336159259 | 67618 | 25-FEB-2022 | Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., |  |  | 67617 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4922 - AGEWELL NEW YORK, LLC | ParkerCare New York, LLC |  |  | 67616 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4853 - BRIGHT HEALTH COMPANY OF ARIZONA | Bright Health Group, Inc. |  |  | 67615 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | Centene Corporation | Website Inquiries | 8888889355 | 67614 | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1436 - ABSOLUTE TOTAL CARE, INC. | Centene Corporation |  |  | 67613 * | 25-FEB-2022 | Health Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7680 - PROMINENCE HEALTHFIRST OF TEXAS | Universal Health Services, Inc. | Libby Belli | 7757709450 | 67612 | 25-FEB-2022 | Health and Drug Benefit | Star Ratings | Less than three (3) Summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S5596 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 67330 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Submit CY 2022 Crosswalk by Bid Deadline | Ad-Hoc CAP-letter.pdf
H5141 - CLOVER INSURANCE COMPANY | Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 66988 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions, Resulting in Plan Correction(s) | Ad-Hoc CAP-letter.pdf
H1248 - LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 66987 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions, Resulting in Plan Correction(s) | Ad-Hoc CAP-letter.pdf
H2986 - Essence Healthcare of California, Inc. | Lumeris Group Holdings Corporation |  |  | 66769 | 24-FEB-2022 | Drug Benefit | Bid Submission | Failure to Comply with CMS CY 2022 Bid Instructions | Ad-Hoc CAP-letter.pdf
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. | Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 64113 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H3204 - PRESBYTERIAN HEALTH PLAN | Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 64112 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H5211 - SECURITY HEALTH PLAN OF WISCONSIN, INC. | Marshfield Clinic Health System, Inc. | Ken Baur | 7152219556 | 64111 | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H0545 - INTER VALLEY HEALTH PLAN, INC. | InterValley Health Plan |  |  | 64110 * | 08-FEB-2022 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2022 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H0490 - MOLINA HEALTHCARE OF OHIO, INC. H9595 - MOLINA HEALTHCARE OF VIRGINIA, INC. | Molina Healthcare, Inc., |  |  | 63550 * | 14-JAN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio (MLR) data. | Ad-Hoc CAP Molina Healthcare Inc. H0490_H9595.pdf
H0150 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY H2165 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H3945 - CIGNA HEALTH AND LIFE INSURANCE COMPANY H4454 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 63551 * | 12-JAN-2022 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio (MLR) data. | Ad-Hoc CAP Cigna_H0150_H2165_H3945_ H4454_ H4528_ H6972sig.pdf
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. H5628 - MOLINA HEALTHCARE OF UTAH, INC. H5810 - MOLINA HEALTHCARE OF CALIFORNIA H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. H7678 - MOLINA HEALTHCARE OF TEXAS, INC. H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., | Member Services | 8006650898, 8006651029, 8006653072, 8553155663, 8664400012, 8886651328 | 63434 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to comply with Medicare Part C and Part D requirements concerning the submission of accurate medical loss ratio data. | Ad-Hoc CAP-letter.pdf
H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. H1415 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H2108 - BRAVO HEALTH MID-ATLANTIC, INC. H3949 - BRAVO HEALTH PENNSYLVANIA, INC. H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4513 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H5410 - HEALTHSPRING OF FLORIDA, INC. H7020 - CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H9460 - CIGNA HEALTHCARE OF ST LOUIS, INC. H9725 - CIGNA HEALTHCARE OF NORTH CAROLINA, INC. S5617 - CIGNA HEALTH AND LIFE INSURANCE COMPANY | The Cigna Group | Jared Rich, Russ Meadows | 8002226700, 8006683813 | 63433 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2016, CY 2017 and CY 2018 reporting year. | Ad-Hoc CAP-letter.pdf
H0571 - CHINESE COMMUNITY HEALTH PLAN | Chinese Hospital Association | Youngsoo Cho | 6282283375 | 63432 | 27-DEC-2021 | Health and Drug Benefit | Reporting Requirements | Failure to submit correct MLR data for the CY 2018 reporting year | Ad-Hoc CAP-letter.pdf
S5805 - UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK S5820 - UNITEDHEALTHCARE INSURANCE COMPANY S8841 - OPTUM INSURANCE OF OHIO, INC. | UnitedHealth Group, Inc. | Mark Britton, Todd Summers | 8664431095, 9529126668 | 62532 | 06-AUG-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H3204 - PRESBYTERIAN HEALTH PLAN H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. | Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 62576 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H1463 - HEALTH ALLIANCE CONNECT, INC. H1737 - HEALTH ALLIANCE - MIDWEST, INC. H2591 - HEALTH ALLIANCE - MIDWEST, INC. H3471 - HEALTH ALLIANCE NORTHWEST HEALTH PLAN S4219 - HEALTH ALLIANCE MEDICAL PLANS | The Carle Foundation | Jennifer Marquardt | 2179029229 | 62575 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
S2668 - MEMBERS HEALTH INSURANCE COMPANY | Tennessee Rural Health Improvement Association | Ryan Brown | 9315600041 | 62574 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H2563 - OPTIMA HEALTH PLAN | Sentara Health Care (SHC) | OPTIMA MEMBER SERVICES | 8009276048 | 62573 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H3811 - SAMARITAN HEALTH PLANS, INC. | Samaritan Health Services | Bridgett Quest | 5417686738 | 62572 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H8578 - HEALTH NEW ENGLAND, INC. | Baystate Health, Inc. | Member Services | 8774433314 | 62571 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H0524 - KAISER FOUNDATION HP, INC. H0630 - KAISER FOUNDATION HP OF CO H1170 - KAISER FOUNDATION HP OF GA, INC. H1230 - KAISER FOUNDATION HP, INC. H2150 - KAISER FNDN HP OF THE MID-ATLANTIC STS H2172 - KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES H5050 - KAISER FOUNDATION HEALTH PLAN OF WASHINGTON H9003 - KAISER FOUNDATION HP OF THE N W | Kaiser Foundation Health Plan, Inc. | Allison Anderson, Member Services, Provider Assistance Unit | 3018166481, 8002324440, 8004430815, 8004762167, 8772218221, 8887674670 | 62570 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H3909 - QCC INSURANCE COMPANY H3952 - KEYSTONE HEALTH PLAN EAST, INC. S6875 - QCC INSURANCE COMPANY | Independence Health Group, Inc. | Customer Service | 8006453965, 8886787009, 8887183333 | 62569 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H1660 - HARVARD PILGRIM HEALTH CARE, INC. H6750 - HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. | Point32Health, Inc. | Kenneth Kayser | 7816121000 | 62568 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
E3014 - PSERS HOP PROGRAM | Commonwealth of PA Pub Schools Retirement System | PSERS HOP Administration Unit | 7173057388 | 62567 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H0354 - CIGNA HEALTHCARE OF ARIZONA, INC. H0439 - CIGNA HEALTHCARE OF GEORGIA, INC. H1415 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H2108 - BRAVO HEALTH MID-ATLANTIC, INC. H3949 - BRAVO HEALTH PENNSYLVANIA, INC. H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4513 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H5410 - HEALTHSPRING OF FLORIDA, INC. H7020 - CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H8423 - Molina Healthcare of Texas, Inc. H9460 - CIGNA HEALTHCARE OF ST LOUIS, INC. H9725 - CIGNA HEALTHCARE OF NORTH CAROLINA, INC. S5617 - CIGNA HEALTH AND LIFE INSURANCE COMPANY | The Cigna Group | Jared Rich, Mike Soltis, Russ Meadows | 8002226700, 8006683813 | 62566 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H5859 - HEALTH PLAN OF CAREOREGON, INC. | CareOregon, Inc. | Whitney Duran Rey | 5034168040 | 62565 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H5587 - HEALTH CHOICE ARIZONA, INC. | Blue Cross Blue Shield of Arizona | Member Services | 8006568991 | 62564 | 26-JUL-2021 | Drug Benefit | Premium and Co-Pay Billing | Failure to Accurately Adjudicate Claims at Point of Sale | Ad-Hoc CAP-letter.pdf
H2793 - IMPERIAL INSURANCE COMPANIES INC. | Imperial Health Plan of California |  |  | 62410 | 29-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to hold proper license. | Imperial_CAP_Final_Revised.pdf
S5596 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 62319 | 10-JUN-2021 | Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf
H9207 - HEALTH PARTNERS PLANS, INC. | Thomas Jefferson University | Sarah Grzyb | 6098657999 | 62318 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf
H3388 - CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. H5042 - CDPHP UNIVERSAL BENEFITS, INC. | Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 5186415275 | 62316 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf
H3471 - HEALTH ALLIANCE NORTHWEST HEALTH PLAN | The Carle Foundation | Jennifer Marquardt | 2179029229 | 62317 | 10-JUN-2021 | Health and Drug Benefit | Plan Corrections | CY 2021 Plan Correction CAP. | Ad-Hoc CAP-letter.pdf
H8764 - ASPIRE HEALTH PLAN | Montage Health | Customer Service | 8555701600 | 62363 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | H8764 - Aspire Health Plan _CAP_Fiscal Soundness _06-09-2021.pdf
H2537 - SPIRITRUST LUTHERAN LIFE | SpiritTrust Lutheran | LouAnn Shively | 5705223880 | 62359 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | H2537 - Spiritrust Lutheran Life _ CAP _ Fiscal Soundness_06-09- 2021.pdf
H0839 - VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC | Volunteers of America National Services | Antionette Hively | 9194253000 | 62360 | 09-JUN-2021 | Health and Drug Benefit | Financial Concerns--Solvency, Reporting, Licensure, Other | Failure to maintain positive net worth | H0839 - VOANS Senior Community Care of NC PACE_ CAP _ Fiscal Soundness_ 06-09-2021.pdf
H3809 - PROVIDENCE HEALTH & SERVICES - OREGON | Providence Health & Services | Rika Bering | 5032156556 | 61930 | 15-JAN-2021 | Drug Benefit | Formulary Submission and Administration | Failure to Meet CY2021 Formulary Requirements | Ad-Hoc CAP-letter.pdf
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. | Vitality Health Plans, Inc. | Member Services | 8663333530 | 61349 | 13-NOV-2020 | Health Benefit | Network adequacy - Health | Failure to meet network adequacy requirements. | H1426_Vitality_Network_Adequacy_CAP.pdf
H2610 - ESSENCE HEALTHCARE, INC. | Lumeris Group Holdings Corporation | Customer Service | 8665979560 | 59068 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf
H1994 - SELECTHEALTH, INC. | Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 59067 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf
H1426 - CCA HEALTH PLANS OF CALIFORNIA, INC. | Vitality Health Plans, Inc. | Member Services | 8663333530 | 59066 | 22-MAY-2020 | Drug Benefit | Bid Submission | Formulary errors identified during bid review | Ad-Hoc CAP-letter.pdf
H5042 - CDPHP UNIVERSAL BENEFITS, INC. | Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 5186415275 | 59065 | 22-MAY-2020 | Drug Benefit | Bid Submission | Failure to comply with CY2020 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
H3388 - CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | Capital District Physicians' Health Plan, Inc. | Dennis Schoonmaker | 5186415275 | 59064 | 22-MAY-2020 | Drug Benefit | Bid Submission | Failure to comply with CY2020 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
H7119 - PROVIDER PARTNERS HEALTH PLAN OF OHIO | Rifkin Managed Care Holding, LLC |  |  | 57184 * | 06-SEP-2019 | Health Benefit | Network adequacy - Health | Failed to have an adequate network. | Provider Partners Health Plan_H7119_CAP_9_6_19_revised.pdf
S4607 - MERIT HEALTH INSURANCE COMPANY | Magellan Health, Inc. |  |  | 55590 * | 29-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6672 - CLEAR SPRING HEALTH (GA), INC. | Eon Health Plan, LLC | Elizabeth Cuevas | 7542085880 | 55589 | 29-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK | The Cigna Group |  |  | 54819 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S2668 - MEMBERS HEALTH INSURANCE COMPANY | Tennessee Rural Health Improvement Association | Ryan Brown | 9315600041 | 54818 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9870 - Justify Holdings, Inc. | University Health Care, Inc. |  |  | 54817 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9153 - WEST VIRGINIA SENIOR ADVANTAGE, INC. | SNP Holdings LLC | Carole Piper | 5136056845 | 54816 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8854 - CareFirst Advantage DSNP, Inc. | University of Maryland Medical System Corporation | Member Services | 8443866762 | 54815 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7173 - PEACH STATE HEALTH PLAN, INC. | Centene Corporation |  |  | 54814 * | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | Elevance Health, Inc. |  |  | 54812 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE | Banner Health | Customer Care | 5208743930 | 54811 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H3928 - AETNA HEALTH INC. (LA) | CVS Health Corporation | Aetna Customer Service | 8883606626 | 54810 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. | Family Health Network | Elizabeth Cuevas | 7542085880 | 54808 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2879 - MOLINA HEALTHCARE OF WISCONSIN, INC. | Molina Healthcare, Inc., | Member Services | 8553155663 | 54807 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54806 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1587 - ARKANSAS SUPERIOR SELECT, INC. | Select Founders, LLC | Customer Service | 5013721922 | 54804 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0174 - WELLCARE OF TEXAS, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54803 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., |  |  | 54802 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8133 - GHS INSURANCE COMPANY | Health Care Service Corporation | Customer Service | 8778956448 | 54801 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6743 - ATRIO HEALTH PLANS | ATRIO Health Plans | Customer Service | 8776728620 | 54799 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5991 - HEALTH INSURANCE PLAN OF GREATER NEW YORK | EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 54798 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5969 - ALOHACARE | AlohaCare | AlohaCare Customer Service | 8089736395 | 54797 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5945 - PROMINENCE HEALTHFIRST | Universal Health Services, Inc. | Libby Belli | 7757709450 | 54796 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5587 - HEALTH CHOICE ARIZONA, INC. | Steward Health Care System, LLC | Member Services | 8006568991 | 54795 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5435 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 54794 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | Elevance Health, Inc. | Customer Service | 8882307338 | 54793 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4922 - AGEWELL NEW YORK, LLC | ParkerCare New York, LLC |  |  | 54792 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4388 - SECURITY HEALTH PLAN OF WISCONSIN, INC. | Marshfield Clinic Health System, Inc. |  |  | 54791 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H4213 - USABLE MUTUAL INSURANCE COMPANY | USAble Mutual Insurance Company | Customer Service | 8442014934 | 54790 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. | Health Care Service Corporation | Customer Service | 8778956448 | 54789 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H3206 - PRESBYTERIAN INSURANCE COMPANY, INC. | Presbyterian Healthcare Services | PCSC Provider Care Unit | 5059235757 | 54788 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2773 - QUALITY HEALTH PLANS OF NEW YORK, INC. | QHP Financial Group, Inc. |  |  | 54787 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1737 - HEALTH ALLIANCE - MIDWEST, INC. | The Carle Foundation | Jennifer Marquardt | 2179029229 | 54786 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1181 - NETWORK HEALTH INSURANCE CORPORATION | Network Health, Inc. | Customer Service | 8003785234 | 54785 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 54784 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 54783 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. | Friday Health Plans, Inc. |  |  | 54782 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 54781 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
S5617 - CIGNA HEALTH AND LIFE INSURANCE COMPANY | The Cigna Group | Russ Meadows | 8002226700 | 54780 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H9403 - CLEAR SPRING HEALTH (SC), INC. | Group 1001 | Elizabeth Cuevas | 7542085880 | 54779 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H7680 - PROMINENCE HEALTHFIRST OF TEXAS | Universal Health Services, Inc. | Libby Belli | 7757709450 | 54778 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8554 - GHS INSURANCE COMPANY | Health Care Service Corporation | Customer Service | 8778956448 | 54777 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8506 - MODA HEALTH PLAN, INC. | Moda Partners, Inc. |  |  | 54776 * | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H8298 - HORIZON HEALTHCARE OF NEW JERSEY, INC. | Horizon Mutual Holdings, Inc | Suze Mestres | 9734665503 | 54775 | 17-APR-2019 | Health Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6396 - CARESOURCE OHIO, INC. | CareSource | Allana Smith | 9296714107 | 54774 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H6988 - CENTERS PLAN FOR HEALTHY LIVING, LLC | Centers Plan for Healthy Living, LLC | Natalie Fernandes | 7182157000 | 54800 | 17-APR-2019 | Health and Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H1894 - AMERIGROUP WASHINGTON, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 54805 | 17-APR-2019 | Drug Benefit | Star Ratings | Less than 3 summary Star Ratings. | Ad-Hoc CAP-letter.pdf
H2459 - UCARE MINNESOTA | UCare Minnesota | Pakou Vang | 6126763585 | 53704 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 53709 | 28-FEB-2019 | Drug Benefit | Formulary Submission and Administration | Failure to properly implement the required Transition Policy | Ad-Hoc CAP-letter.pdf
H1994 - SELECTHEALTH, INC. | Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 53708 | 28-FEB-2019 | Drug Benefit | Formulary Submission and Administration | Failure to properly implement the required Transition Policy | Ad-Hoc CAP-letter.pdf
S4219 - HEALTH ALLIANCE MEDICAL PLANS | The Carle Foundation | Jennifer Marquardt | 2179029229 | 53721 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S5609 - ASURIS NORTHWEST HEALTH | Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 53722 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S5916 - REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH | Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 53723 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S9701 - DEAN HEALTH INSURANCE, INC. | SSM Health Care Corporation | Scott Jacoby | 9202214087 | 53724 | 28-FEB-2019 | Drug Benefit | Bid Submission | Failure to comply with CY2019 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S1894 - COMMUNITYCARE GOVERNMENT PROGRAMS, INC. | St Francis Health System & St John Health System |  |  | 52561 * | 02-JAN-2019 | Drug Benefit | 4Rx Submission and Accuracy Problems | PCN/BIN must be completed for 99% of all enrollments | Ad-Hoc CAP-letter.pdf
H7971 - HORIZON INSURANCE COMPANY | Horizon Mutual Holdings, Inc |  |  | 51478 * | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H3815 - ALIGNMENT HEALTH PLAN | Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 51473 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H0104 - BLUE CROSS AND BLUE SHIELD OF ALABAMA | BlueCross BlueShield of Alabama | Jeff Corley | 8005176425 | 51469 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H1189 - CHRISTUS HEALTH PLAN | CHRISTUS Health | Ronda Hefton | 8442823026 | 51472 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H7220 - INDIANA UNIVERSITY HEALTH PLANS NFP, INC. | Indiana University Health | Nina Barrow | 8004559776 | 51476 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H1170 - KAISER FOUNDATION HP OF GA, INC. | Kaiser Foundation Health Plan, Inc. | Member Services | 8002324440 | 51471 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H9576 - NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND | NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND | Lisa Carcieri | 4014596008 | 51479 | 02-NOV-2018 | Drug Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H0423 - METROPLUS HEALTH PLAN, INC. | New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 51470 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H5386 - SHARP HEALTH PLAN | Sharp Healthcare | Leslie Pels-Beck | 8584998244 | 51474 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H5945 - PROMINENCE HEALTHFIRST | Universal Health Services, Inc. | Libby Belli | 7757709450 | 51475 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H7680 - PROMINENCE HEALTHFIRST OF TEXAS | Universal Health Services, Inc. | Libby Belli | 7757709450 | 51477 | 02-NOV-2018 | Health Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
S5753 - WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | Wisconsin Physicians Service Ins Corporation. |  |  | 51480 * | 02-NOV-2018 | Drug Benefit | Reporting Requirements | Did not meet the reporting requirements data validation passing threshold of 95% | Ad-Hoc CAP-letter.pdf
H1189 - CHRISTUS HEALTH PLAN | CHRISTUS Health | Ronda Hefton | 8442823026 | 52042 | 18-OCT-2018 | Health and Drug Benefit | Call Center Requirements | See attachment | H1189_CAP_Interpreter Availability_2018.pdf
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION | Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 52041 | 18-OCT-2018 | Drug Benefit | Call Center Requirements | See attachment | S5877_CAP_Interpreter Availability_2018.pdf
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. | Health Care Service Corporation | Customer Service | 8778956448 | 48606 | 28-FEB-2018 | Drug Benefit | 4Rx Submission and Accuracy Problems | CAP is requested when errors remain after Warninig letter is sent. | Ad-Hoc CAP-letter.pdf
H1994 - SELECTHEALTH, INC. | Intermountain Health Care, Inc. | Mark Richardson | 8014428210 | 48651 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf
S5601 - SILVERSCRIPT INSURANCE COMPANY | CVS Health Corporation | Kelly Devine | 8662355660 | 48652 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 48654 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf
H1977 - UPPER PENINSULA HEALTH PLAN, LLC | DLP Marquette General Hospital, LLC | Nicole Stewart | 9062321601 | 48655 | 28-FEB-2018 | Drug Benefit | Formulary Submission and Administration | Failing to properly implement the required transition policy | Ad-Hoc CAP-letter.pdf
H5141 - CLOVER INSURANCE COMPANY | Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 48686 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
H9047 - PROVIDENCE HEALTH ASSURANCE | Providence Health & Services | Misty Dunphy | 5035746608 | 48687 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S8899 - TAKECARE INSURANCE COMPANY, INC. | TakeCare Health Systems |  |  | 48688 * | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S7694 - ELIXIR INSURANCE COMPANY | Rite Aid Corporation | Customer Service | 8662502005 | 48689 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
S5795 - USABLE MUTUAL INSURANCE COMPANY | USAble Mutual Insurance Company | Customer Service | 8442014934 | 48690 | 28-FEB-2018 | Drug Benefit | Bid Submission | Failure to comply with CY2018 Part D bid submission requirements. | Ad-Hoc CAP-letter.pdf
H1099 - HEALTH FIRST HEALTH PLANS | Health First Shared Services, Inc. | Katie Fleming | 8445225282 | 48202 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1189 - CHRISTUS HEALTH PLAN | CHRISTUS Health | Ronda Hefton | 8442823026 | 48203 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1394 - HMO COLORADO, INC. | Elevance Health, Inc. |  |  | 48204 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1517 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. |  |  | 48205 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1607 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48306 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. | Elevance Health, Inc. |  |  | 48307 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H1894 - AMERIGROUP WASHINGTON, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48308 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2224 - SENIOR WHOLE HEALTH, LLC | Magellan Health, Inc. | Member Services | 8006650898 | 48309 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2230 - BCBS OF MASSACHUSETTS HMO BLUE, INC. | Blue Cross and Blue Shield of Massachusetts, Inc. | Member Services | 8002004255 | 48310 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2261 - BCBS OF MASSACHUSETTS HMO BLUE, INC. | Blue Cross and Blue Shield of Massachusetts, Inc. | Member Services | 8002004255 | 48311 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2320 - PRIORITY HEALTH | Corewell Health | Customer Service | 8883896648 | 48312 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2456 - UCARE MINNESOTA | UCare Minnesota | Pakou Vang | 6126763585 | 48313 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H2459 - UCARE MINNESOTA | UCare Minnesota | Pakou Vang | 6126763585 | 48314 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3233 - PREMIER HEALTH INSURING CORPORATION | Premier Health Partners |  |  | 48315 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3240 - AMERIGROUP NEW JERSEY, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48316 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3259 - VOLUNTEER STATE HEALTH PLAN | BlueCross BlueShield of Tennessee | Customer Service | 8002991407 | 48317 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3330 - HEALTH INSURANCE PLAN OF GREATER NEW YORK | EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 48318 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3335 - EXCELLUS HEALTH PLAN, INC. | Lifetime Healthcare, Inc. | Colleen Myrto | 3156718498 | 48319 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3342 - EMPIRE HEALTHCHOICE ASSURANCE, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48320 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3351 - EXCELLUS HEALTH PLAN, INC. | Lifetime Healthcare, Inc. | Colleen Myrto | 3156718498 | 48321 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3370 - EMPIRE HEALTHCHOICE HMO, INC. | Elevance Health, Inc. |  |  | 48322 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3384 - Highmark Western and Northeastern New York Inc. | HealthNow New York Inc. | Customer Service | 8773271395 | 48323 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3447 - HEALTHKEEPERS, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48324 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3528 - CONNECTICARE, INC. | EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 48325 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3536 - MATTHEW THORNTON HEALTH PLAN, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48326 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3655 - COMMUNITY INSURANCE COMPANY | Elevance Health, Inc. | Customer Service | 8882307338 | 48327 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3672 - THE HEALTH PLAN OF WEST VIRGINIA, INC. | The Health Plan of West Virginia, Inc. | Penny Richard | 7406957597 | 48328 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3907 - UPMC HEALTH PLAN, INC. | UPMC Health System | Medicare Marketing | 8773813765 | 48329 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3916 - HIGHMARK SENIOR HEALTH COMPANY | Highmark Health | Provider Service | 8665886967 | 48330 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H3957 - HIGHMARK CHOICE COMPANY | Highmark Health | Provider Service | 8665886967 | 48331 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H4036 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48332 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H4279 - UPMC FOR YOU, INC | UPMC Health System | Medicare Marketing | 8773813765 | 48333 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H4497 - MEDICAL MUTUAL OF OHIO | MEDICAL MUTUAL OF OHIO | Shirra Subsinsky | 8003621279 | 48334 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H4875 - PRIORITY HEALTH | Corewell Health | Customer Service | 8883896648 | 48335 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H4909 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48336 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5106 - HIGHMARK SENIOR SOLUTIONS COMPANY | Highmark Health | Provider Service | 8665886967 | 48337 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5215 - NETWORK HEALTH INSURANCE CORPORATION | Network Health, Inc. | Customer Service | 8003785234 | 48338 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | Elevance Health, Inc. | Customer Service | 8882307338 | 48339 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5425 - SCAN HEALTH PLAN | SCAN Health Plan | Kim McBeath | 8777787226 | 48340 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5471 - SIMPLY HEALTHCARE PLANS, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48341 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5526 - Highmark Western and Northeastern New York Inc. | HealthNow New York Inc. | Customer Service | 8773271395 | 48342 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. | Elevance Health, Inc. |  |  | 48343 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5533 - UPMC HEALTH NETWORK, INC. | UPMC Health System | Medicare Marketing | 8773813765 | 48344 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | Elevance Health, Inc. |  |  | 48345 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5817 - AMERIGROUP TEXAS, INC. | Elevance Health, Inc. |  |  | 48346 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON | Community Health Plan of Washington | Customer Care | 8009420247 | 48347 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5854 - ANTHEM HEALTH PLANS, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48348 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5937 - UCARE MINNESOTA | UCare Minnesota | Pakou Vang | 6126763585 | 48350 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5943 - SCAN HEALTH PLAN | SCAN Health Plan | Kim McBeath | 8777787226 | 48351 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5969 - ALOHACARE | AlohaCare | AlohaCare Customer Service | 8089736395 | 48352 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H5992 - SENIOR WHOLE HEALTH OF NEW YORK, INC. | Magellan Health, Inc. | Member Services | 8006650898 | 48353 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6229 - BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | Elevance Health, Inc. |  |  | 48354 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6298 - MEDICAL MUTUAL OF OHIO | MEDICAL MUTUAL OF OHIO |  |  | 48355 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6453 - HMO LOUISIANA, INC. | Louisiana Health Service & Indemnity Company | Customer Service | 8665087145 | 48356 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6723 - MEDICAL MUTUAL OF OHIO | MEDICAL MUTUAL OF OHIO | Shirra Subsinsky | 8003621279 | 48357 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6786 - ANTHEM HEALTH PLANS OF MAINE, INC. | Elevance Health, Inc. |  |  | 48358 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H6864 - GUILDNET, INC. | Jewish Guild for the Blind |  |  | 48359 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H7200 - AMERIGROUP TENNESSEE, INC. | Elevance Health, Inc. |  |  | 48360 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H7728 - ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | Elevance Health, Inc. |  |  | 48361 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H7917 - BLUECROSS BLUESHIELD OF TENNESSEE, INC. | BlueCross BlueShield of Tennessee | Customer Service | 8008312583 | 48362 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8146 - SECURITYCARE OF TENNESSEE, INC. | BlueCross BlueShield of Tennessee |  |  | 48363 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8289 - BAPTIST HEALTH PLAN, INC. | Baptist Healthcare System |  |  | 48364 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8432 - EMPIRE HEALTHCHOICE HMO, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48365 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY | Elevance Health, Inc. | Customer Service | 8882307338 | 48366 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8604 - THP INSURANCE COMPANY | The Health Plan of West Virginia, Inc. | Penny Richard | 7406957597 | 48367 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8786 - AMERIGROUP TEXAS, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48368 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H8851 - SENIOR WHOLE HEALTH OF NEW YORK, INC. | Magellan Health, Inc. |  |  | 48369 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9104 - SCAN HEALTH PLAN | SCAN Health Plan | Kim McBeath | 8777787226 | 48370 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9487 - MICHIGAN COMPLETE HEALTH, INC. | Centene Corporation |  |  | 48371 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9525 - COMPCARE HEALTH SERVICES INSURANCE CORPORATION | Elevance Health, Inc. | Customer Service | 8882307338 | 48372 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9886 - HMO MISSOURI, INC. | Elevance Health, Inc. |  |  | 48374 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9915 - MEDSTAR FAMILY CHOICE, INC. | Medstar Health, Inc. |  |  | 48375 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | Elevance Health, Inc. |  |  | 48376 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H9954 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. |  |  | 48377 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
R5941 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48378 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5593 - HM HEALTH INSURANCE COMPANY | Highmark Health | Provider Service | 8665886967 | 48380 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5596 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 48381 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5660 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | Express Scripts Holding Company | Customer Service | 8007584574 | 48382 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5726 - BLUE CROSS AND BLUE SHIELD OF KANSAS | Blue Cross Blue Shield of Kansas | Customer Service | 8882307338 | 48383 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5753 - WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | Wisconsin Physicians Service Ins Corporation. |  |  | 48384 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION | Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 48385 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H0811 - GUILDNET, INC. | Jewish Guild for the Blind |  |  | 48201 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H0735 - UCARE MINNESOTA | UCare Minnesota |  |  | 48200 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H0564 - BLUE CROSS OF CALIFORNIA | Elevance Health, Inc. |  |  | 48199 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
H0147 - HEALTHKEEPERS, INC. | Elevance Health, Inc. |  |  | 48198 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK | Express Scripts Holding Company |  |  | 48386 * | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission | Ad-Hoc CAP-letter.pdf
S5660 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY S5983 - MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK | Express Scripts Holding Company | Customer Service | 8007584574 | 48197 | 19-JAN-2018 | Drug Benefit | Plan Finder Data | Pharmacies excluded from MPF data submission. | Ad-Hoc CAP-letter.pdf
H1189 - CHRISTUS HEALTH PLAN | CHRISTUS Health | Ronda Hefton | 8442823026 | 47308 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H1189_CAP.pdf
H0148 - BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN | California Physicians' Service |  |  | 47306 * | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H0148_CAP.pdf
H5928 - California Physicians' Service | California Physicians' Service | Member Services | 8007764466 | 47387 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H5928_CAP.pdf
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. | Colorado Choice Health Plans |  |  | 47307 * | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H0657_CAP.pdf
H5938 - CAPITAL HEALTH PLAN | Guidewell Mutual Holding Corporation | Beth Maige | 8505237307 | 47388 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H5938_CAP.pdf
H9712 - HAP EMPOWERED HEALTH PLAN, INC. | Henry Ford Health System | Heather Spencer | 2487763808 | 47391 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H9712_CAP_ Updated_CAM ID 47391.pdf
H2237 - INDEPENDENT CARE HEALTH PLAN | Independent Care Health Plan Inc. | Lisa Richter | 8004486262 | 47309 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H2237_CAP.pdf
H0332 - KS PLAN ADMINISTRATORS, LLC | Kelsey-Seybold Medical Group, PLLC | Member Services | 8665358343 | 47326 | 08-DEC-2017 | Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H0332_CAP_CAM ID 47326.pdf
H3706 - GLOBALHEALTH, INC. | MHH Healthcare, L.P. | Daniel Thomas | 4055261126 | 47386 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H3706_CAP.pdf
H2458 - MEDICA HEALTH PLANS | Medica Holding Company | Customer Service | 8002348755 | 47346 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H2458_CAP.pdf
H3653 - PARAMOUNT CARE, INC. | Promedica Health System, Inc. | Member Services | 8004623589 | 47367 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H3653_CAP.pdf
H7890 - SANTA CLARA COUNTY HEALTH AUTHORITY | SANTA CLARA COUNTY HEALTH AUTHORITY |  |  | 47389 * | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H7890_CAP.pdf
H2986 - Essence Healthcare of California, Inc. | Stanford Health Care |  |  | 47366 | 08-DEC-2017 | Health and Drug Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H2986_CAP.pdf
H8854 - CareFirst Advantage DSNP, Inc. | University of Maryland Medical System Corporation | Member Services | 8443866762 | 47390 | 08-DEC-2017 | Health Benefit | Reporting Requirements | Organization did not pass its data validation (2016 reporting requirements data validated in 2017) | H8854_CAP.pdf
H5779 - MERIDIAN HEALTH PLAN OF ILLINOIS, INC. | Caidan Enterprises, Inc. | Provider Services | 8662968731 | 45621 | 06-JUL-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating for Part D. | Ad-Hoc CAP-letter.pdf
H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 45622 * | 06-JUL-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating for Part C. | Ad-Hoc CAP-letter.pdf
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE | Banner Health | Customer Care | 5208743930 | 45504 | 14-JUN-2017 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2017 Inaccurate ANOC/EOC | H4931_AdHocCAP_2017_ANOCEOC_Inaccurate.pdf
H8237 - INSURANCE COMPANY OF SCOTT AND WHITE | Baylor Scott & White Holdings |  |  | 45531 * | 14-JUN-2017 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2017 Inaccurate ANOC/EOC | H8237_AdHocCAP_2017_ANOCEOC_Inaccurate.pdf
E7316 - UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS | Union Pacific Railroad Employes Health Systems |  |  | 45263 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H0490 - MOLINA HEALTHCARE OF OHIO, INC. | Molina Healthcare, Inc., |  |  | 45264 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. | Colorado Choice Health Plans |  |  | 45265 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45266 | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H1264 - WELLCARE OF TEXAS, INC. | WellCare Health Plans, Inc. |  |  | 45267 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H1416 - HARMONY HEALTH PLAN, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45268 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3071 - CLEAR SPRING HEALTH COMMUNITY CARE, INC. | Family Health Network | Elizabeth Cuevas | 7542085880 | 45270 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3347 - ELDERPLAN, INC. | Elderplan, Inc. | Doretha Alston | 7189217979 | 45271 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3361 - WELLCARE OF NEW YORK, INC. | WellCare Health Plans, Inc. |  |  | 45272 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3945 - CIGNA HEALTH AND LIFE INSURANCE COMPANY | The Cigna Group |  |  | 45273 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3979 - GHS HEALTH MAINTENANCE ORGANIZATION, INC. | Health Care Service Corporation | Customer Service | 8778956448 | 45274 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3154 - HORIZON INSURANCE COMPANY | Horizon Mutual Holdings, Inc |  |  | 45275 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H5087 - WELLCARE OF CALIFORNIA, INC. | WellCare Health Plans, Inc. | Provider Services | 8662968731 | 45276 | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H5549 - VNS CHOICE | Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 45277 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H5685 - HAP MIDWEST HEALTH PLAN, INC. | Henry Ford Health System |  |  | 45278 * | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H5945 - PROMINENCE HEALTHFIRST | Universal Health Services, Inc. | Libby Belli | 7757709450 | 45280 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H5991 - HEALTH INSURANCE PLAN OF GREATER NEW YORK | Affinity Health Services Holdings, Inc. | Priyank Pandey | 6464477543 | 45281 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H6298 - MEDICAL MUTUAL OF OHIO | MEDICAL MUTUAL OF OHIO |  |  | 45282 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. | Health Care Service Corporation |  |  | 45283 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. | Humana Inc. |  |  | 45301 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group | Jared Rich | 8006683813 | 45303 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H8266 - CONSTELLATION HEALTH, LLC. | Constellation Health, LLC. |  |  | 45304 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H8634 - HEALTH CARE SERVICE CORPORATION | Health Care Service Corporation | Customer Service | 8778956448 | 45305 | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H9190 - GATEWAY HEALTH PLAN OF OHIO, INC. | Gateway Health, LLC. |  |  | 45306 * | 13-JUN-2017 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | Elevance Health, Inc. |  |  | 45307 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
S0522 - SYMPHONIX HEALTH INSURANCE, INC. | UnitedHealth Group, Inc. |  |  | 45308 * | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
S4802 - WELLCARE PRESCRIPTION INSURANCE, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 45309 | 13-JUN-2017 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H3054 - CONSTELLATION HEALTH, LLC. | Constellation Health, LLC. |  |  | 45269 * | 13-JUN-2017 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2017 overall star rating. | Ad-Hoc CAP-letter.pdf
H4931 - BANNER - UNIVERSITY CARE ADVANTAGE | Banner Health | Customer Care | 5208743930 | 45221 | 19-MAY-2017 | Health and Drug Benefit | Bid Submission | University Care Advantage failed to provide any substantiation for there CY2017 Bid Submission. | Banner_CAP_5-19-2017.pdf
H0028 - CHA HMO, INC. H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0336 - HUMANA HEALTH PLAN, INC. H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1291 - HUMANA INSURANCE COMPANY OF NEW YORK H1406 - HUMANA HEALTH PLAN, INC. H1418 - HUMANA INSURANCE COMPANY H1468 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H1510 - HUMANA INSURANCE COMPANY H1716 - HUMANA INSURANCE COMPANY H1906 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2486 - HUMANA MEDICAL PLAN OF UTAH, INC. H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H3480 - HUMANA HEALTH PLAN, INC. H3533 - HUMANA HEALTH COMPANY OF NEW YORK, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4145 - HUMANA REGIONAL HEALTH PLAN, INC. H4461 - CARITEN HEALTH PLAN INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H5216 - HUMANA INSURANCE COMPANY H5415 - HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. H5525 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H5619 - ARCADIAN HEALTH PLAN, INC. H5970 - HUMANA INSURANCE COMPANY OF NEW YORK H6609 - HUMANA INSURANCE COMPANY H6622 - HUMANA WI HEALTH ORGANIZATION INSURANCE CORP H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. H8145 - HUMANA INSURANCE COMPANY H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. H8953 - HUMANA HEALTH PLAN OF OHIO, INC. R5826 - HUMANA INSURANCE COMPANY S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. S5552 - HUMANA INSURANCE COMPANY OF NEW YORK S5884 - HUMANA INSURANCE COMPANY | Humana Inc. | Lisa Richter | 8004486262 | 42899 | 31-AUG-2016 | Drug Benefit | Marketing--Website and Social Media | During the 2015 plan year, Humana maintained for all of its Part D contracts three online sources of information concerning its network pharmacies: the pharmacy search tool (PST), the pharmacy directory search tool (PDST), and the annual price estimate tool (PET).\nWith the PST, beneficiaries could search for pharmacies in a particular portion of Humana's service area, while they could use the PDST to obtain PDF versions of network pharmacy lists for each of the states in Humana's service area. The PET offered beneficiaries the opportunity to select a pharmacy from among those listed in Humana's contracted Part D network and to receive information about the plan's negotiated prices for prescription drugs identified by the beneficiary. Each of these web-based pharmacy network information resources was out of compliance with Part D requirements during 2015. | Humana Pharmacy Website CAP August 31 2016.pdf
H5141 - CLOVER INSURANCE COMPANY | Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 42000 | 29-JUL-2016 | Health Benefit | Notification to CMS of Administrative Changes | Failure to submit change of ownership documents prior to transaction. | Clover_H5141_CHOW_CAP_Final_Reissued_4_19_17.pdf
H2322 - ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | Henry Ford Health System | Heather Spencer | 2487763808 | 41561 | 19-JUL-2016 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY2016 Inaccurate ANOC/EOC | H2322_AdHocCAP_2016_InaccurateANOCEOC_HandRcontracts_03182016.pdf
H5007 - PROVIDENCE HEALTH SYSTEM | Providence Health & Services | Rika Bering | 5032153857 | 41260 | 11-JUL-2016 | Drug Benefit | Payment Process | CMS is issuing this notice based on Providence's failure to comply with Part D program requirements regarding the timely submission of Prescription Drug Event (PDE) data to CMS. CMS has also issued to Providence under this contract ID a Notice of Non-compliance (NoNC) on September 3, 2014, and a Warning Letter (WL) on December 4, 2014, for similar instances of non-compliance. For fourth quarter of 2014, the sponsor missed the November submission, making it the third quarter in a rom with missing submissions. | H5007 Providence Health System CAP PDE Submissions Q4 2014 emailed.pdf
H3890 - HOPKINS HEALTH ADVANTAGE, INC. | Johns Hopkins Healthcare LLC | Salma Riaz | 4107625905 | 41068 | 21-JUN-2016 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY2016 Inaccurate ANOC/EOC | H3890_AdHocCAP_2016_InaccurateANOCEOC_HandRcontracts_03182016.pdf
H3312 - AETNA HEALTH INC. (NY) H5521 - AETNA LIFE INSURANCE COMPANY | Aetna Inc. | Aetna Customer Service | 8006240756 | 38900 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | Aetna H3312 H5521 Initial Bid Submission san.pdf
H0504 - CALIFORNIA PHYSICIANS' SERVICE | California Physicians' Service | Member Services | 8007764466 | 38902 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | California Physicians' Service H0504 san.pdf
H1304 - REGENCE BLUESHIELD OF IDAHO, INC. | Cambia Health Solutions, Inc. | Catina Ciuro | 5416181268 | 38906 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | Regence Blue Shield of Idaho H1304 san.pdf
S6311 - QUALCHOICE ADVANTAGE | Catholic Health Initiatives |  |  | 38905 * | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | Qualchoice Advantage S6311 san.pdf
H0107 - HEALTH CARE SERVICE CORPORATION H1666 - HCSC INSURANCE SERVICES COMPANY H8634 - HEALTH CARE SERVICE CORPORATION | Health Care Service Corporation | Customer Service | 8778956448 | 38903 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | Health Care Service Corp H0107 - H1666 - H8634 san.pdf
H9207 - HEALTH PARTNERS PLANS, INC. | Thomas Jefferson University | Sarah Grzyb | 6098657999 | 38904 | 29-FEB-2016 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2016 Part D bid submission requirements. In specific, the failure to offer a MAPD/PDP Basic offering. | Health Partners Plans Inc H9207 san.pdf
H1493 - CARESOURCE KENTUCKY CO. H9162 - CARESOURCE INDIANA, INC. | CareSource |  |  | 39621 * | 17-FEB-2016 | Health Benefit | Network adequacy - Health | On December 4, 2015, CareSource first notified CMS of significant errors in the HSD tables submitted during the MA application process. CMS used the inaccurate HSD tables to approve the application, specifically in the determination that the network was sufficient to meet the health care needs of beneficiaries in the defined service area. | CareSource Corrective Action Plan Final 02172016.pdf
S5755 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 38723 * | 12-FEB-2016 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 2016_4RxCAP_Letter_san.pdf
H5302 - AETNA HEALTH INC. (GA) | Aetna Inc. | Aetna Customer Service | 8006240756 | 38080 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H5302_CAP Letter for Low Star ratings.pdf
H2174 - TRILLIUM COMMUNITY HEALTH PLAN, INC. | Agate Resources, Inc. | Provider Services | 8448671156 | 38041 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H2174_CAP Letter for Low Star ratings.pdf
H3815 - ALIGNMENT HEALTH PLAN | Alignment Healthcare USA, LLC | Dawn Maroney | 8443102247 | 38053 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3815_CAP Letter for Low Star ratings.pdf
H9285 - ATLANTIS HEALTH PLAN, INC. | America's 1st Choice NY Holdings, LLC |  |  | 38075 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H9285_CAP Letter for Low Star ratings.pdf
H8237 - INSURANCE COMPANY OF SCOTT AND WHITE | Baylor Scott & White Holdings |  |  | 38071 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H8237_CAP Letter for Low Star ratings.pdf
S7230 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Caidan Enterprises, Inc. |  |  | 38083 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S7230_CAP Letter for Low Star ratings.pdf
H5141 - CLOVER INSURANCE COMPANY | Clover Health Holdings, Inc. | Wendy Richey | 5512252014 | 38065 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H5141_CAP Letter for Low Star ratings.pdf
H0657 - FRIDAY HEALTH PLANS OF COLORADO, INC. | Colorado Choice Health Plans |  |  | 38036 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H0657_CAP Letter for Low Star ratings.pdf
H3054 - CONSTELLATION HEALTH, LLC. | Constellation Health, LLC. |  |  | 38051 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3054_CAP Letter for Low Star ratings.pdf
H8266 - CONSTELLATION HEALTH, LLC. | Constellation Health, LLC. |  |  | 38346 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H8266_CAP Letter for Low Star ratings.pdf
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | Elevance Health, Inc. |  |  | 38072 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H9947_CAP Letter for Low Star ratings.pdf
S0522 - SYMPHONIX HEALTH INSURANCE, INC. | Granite Creek FlexCap LLP |  |  | 38073 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S0522_CAP Letter for Low Star ratings.pdf
S5904 - BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. | Guidewell Mutual Holding Corporation | Medicare Mbr Svcs | 8009266565 | 38084 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S5904_CAP Letter for Low Star ratings.pdf
H1666 - HCSC INSURANCE SERVICES COMPANY | Health Care Service Corporation | Customer Service | 8778956448 | 38040 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H1666_CAP Letter for Low Star ratings.pdf
H3251 - HEALTH CARE SERVICE CORPORATION | Health Care Service Corporation | Customer Service | 8778956448 | 38047 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3251_CAP Letter for Low Star ratings.pdf
H3822 - HEALTH CARE SERVICE CORPORATION | Health Care Service Corporation | Customer Service | 8778956448 | 38048 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3822_CAP Letter for Low Star ratings.pdf
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. | Health Care Service Corporation |  |  | 38049 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H6801_CAP Letter for Low Star ratings.pdf
S1140 - Highmark Western and Northeastern New York Inc. | HealthNow New York Inc. | Customer Service | 8773271395 | 38076 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S1140_CAP Letter for Low Star ratings.pdf
H3708 - OKLAHOMA SUPERIOR SELECT, INC. | Healthcare Investors, LLC | Jennifer Bridgeforth | 6159055424 | 38052 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3708_CAP Letter for Low Star ratings.pdf
S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 38074 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S2874_CAP Letter for Low Star ratings.pdf
H4227 - VISTA HEALTH PLAN, INC. | Independence Health Group, Inc. | Provider Services | 8005216007 | 38063 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H4227_CAP Letter for Low Star ratings.pdf
H2241 - GOLDEN STATE MEDICARE HEALTH PLAN | MacArthur Court Acquisition Corp |  |  | 38062 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H2241_CAP Letter for Low Star ratings.pdf
H9122 - ALPHACARE OF NEW YORK, INC. | Magellan Health, Inc. |  |  | 38066 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H9122_CAP Letter for Low Star ratings.pdf
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. | Molina Healthcare, Inc., |  |  | 38070 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H8130_CAP Letter for Low Star ratings.pdf
H5810 - MOLINA HEALTHCARE OF CALIFORNIA | Molina Healthcare, Inc., | Member Services | 8006650898 | 38081 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H5810_CAP Letter for Low Star ratings.pdf
H5985 - PHOENIX HEALTH PLANS, INC. | Tenet Healthcare Corporation |  |  | 38082 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H5985_CAP Letter for Low Star ratings.pdf
H2108 - BRAVO HEALTH MID-ATLANTIC, INC. | The Cigna Group | Jared Rich | 8006683813 | 38060 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H2108_CAP Letter for Low Star ratings.pdf
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 38064 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H4528_CAP Letter for Low Star ratings.pdf
H6972 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 38068 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H6972_CAP Letter for Low Star ratings.pdf
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group | Jared Rich | 8006683813 | 38069 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H7787_CAP Letter for Low Star ratings.pdf
S5580 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 38050 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S5580_CAP Letter for Low Star ratings.pdf
S5755 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 38061 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S5755_CAP Letter for Low Star ratings.pdf
H4213 - USABLE MUTUAL INSURANCE COMPANY | USAble Mutual Insurance Company | Customer Service | 8442014934 | 38054 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H4213_CAP Letter for Low Star ratings.pdf
S8841 - OPTUM INSURANCE OF OHIO, INC. | UnitedHealth Group, Inc. | Todd Summers | 8664431095 | 38067 | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S8841_CAP Letter for Low Star ratings.pdf
H0712 - WELLCARE OF CONNECTICUT, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38037 | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H0712_CAP Letter for Low Star ratings.pdf
H1112 - WELLCARE OF GEORGIA, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38038 | 08-DEC-2015 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H1112_CAP Letter for Low Star ratings.pdf
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. |  |  | 38039 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H1903_CAP Letter for Low Star ratings.pdf
H3361 - WELLCARE OF NEW YORK, INC. | WellCare Health Plans, Inc. |  |  | 38043 * | 08-DEC-2015 | Health Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H3361_CAP Letter for Low Star ratings.pdf
H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 38044 | 08-DEC-2015 | Health and Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | H9730_CAP Letter for Low Star ratings.pdf
S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. | WellCare Health Plans, Inc. |  |  | 38045 * | 08-DEC-2015 | Drug Benefit | Star Ratings | Failure to achieve at least three stars for its 2016 overall star rating. | S5967_CAP Letter for Low Star ratings.pdf
H5508 - ADVANTAGE HEALTH SOLUTIONS, INC. | Advantage Health Solutions |  |  | 36980 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5508_CAP Letter for Low Star ratings.pdf
H5969 - ALOHACARE | AlohaCare | AlohaCare Customer Service | 8089736395 | 36968 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5969_CAP Letter for Low Star ratings.pdf
H9285 - ATLANTIS HEALTH PLAN, INC. | America's 1st Choice NY Holdings, LLC |  |  | 36977 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H9285_CAP Letter for Low Star ratings.pdf
H5475 - MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Caidan Enterprises, Inc. | Provider Services | 8662968731 | 36965 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5475_CAP Letter for Low Star ratings.pdf
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8662968731 | 36908 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0908_CAP Letter for Low Star ratings.pdf
H2323 - FIDELIS SECURECARE OF MICHIGAN | Centene Corporation |  |  | 36912 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H2323_CAP Letter for Low Star ratings.pdf
H5294 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Member Services | 8779358023 | 36964 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5294_CAP Letter for Low Star ratings.pdf
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. | Centene Corporation | Provider Services | 8002229831 | 36976 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H8189_CAP Letter for Low Star ratings.pdf
H0621 - COLORADO ACCESS | Colorado Access |  |  | 36906 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0621_CAP Letter for Low Star ratings.pdf
H4866 - CUATRO LLC | Cuatro LLC. |  |  | 36963 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H4866_CAP Letter for Low Star ratings.pdf
H2161 - UPPER PENINSULA HEALTH PLAN, LLC | DLP Marquette General Hospital, LLC |  |  | 36911 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H2161_CAP Letter for Low Star ratings.pdf
H1517 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. |  |  | 36924 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H1517_CAP Letter for Low Star ratings.pdf
H7200 - AMERIGROUP TENNESSEE, INC. | Elevance Health, Inc. |  |  | 36972 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H7200_CAP Letter for Low Star ratings.pdf
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | Elevance Health, Inc. |  |  | 36984 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5746_CAP Letter for Low Star ratings.pdf
H5528 - EMBLEMHEALTH PLAN, INC. | EmblemHealth, Inc. | Priyank Pandey | 6464477543 | 36981 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5528_CAP Letter for Low Star ratings.pdf
S0064 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT OF NY | Express Scripts Holding Company |  |  | 37000 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | S0064_CAP Letter for Low Star ratings.pdf
H5932 - GATEWAY HEALTH PLAN, INC. | Gateway Health, LLC. | Josh Hartman | 8006855209 | 36966 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5932_CAP Letter for Low Star ratings.pdf
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. | Health Care Service Corporation |  |  | 36971 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H6801_CAP Letter for Low Star ratings.pdf
S3474 - HEARTLAND FIDELITY INSURANCE COMPANY | Heartland Fidelity Insurance Company |  |  | 37001 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | S3474_CAP Letter for Low Star ratings.pdf
H5685 - HAP MIDWEST HEALTH PLAN, INC. | Henry Ford Health System |  |  | 36982 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5685_CAP Letter for Low Star ratings.pdf
H5887 - MMM HEALTHCARE, LLC. | InnovaCare Inc. |  |  | 36986 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5887_CAP Letter for Low Star ratings.pdf
H3337 - LIBERTY HEALTH ADVANTAGE, INC. | Liberty Health Advantage, Inc. |  |  | 36916 * | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H3337_CAP Letter for Low Star ratings.pdf
H0141 - MCLAREN HEALTH PLAN, INC. | McLaren Health Care Corporation |  |  | 36903 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0141_CAP Letter for Low Star ratings.pdf
H0490 - MOLINA HEALTHCARE OF OHIO, INC. | Molina Healthcare, Inc., |  |  | 36904 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0490_CAP Letter for Low Star ratings.pdf
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. | Molina Healthcare, Inc., | Member Services | 8664400012 | 36973 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H7678_CAP Letter for Low Star ratings.pdf
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. | Molina Healthcare, Inc., | Member Services | 8006651029 | 36985 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5823_CAP Letter for Low Star ratings.pdf
H1659 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | Piedmont Community Health Plan | Mark Britton | 9529126668 | 36925 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H1659_CAP Letter for Low Star ratings.pdf
H5943 - SCAN HEALTH PLAN | SCAN Health Plan | Kim McBeath | 8777787226 | 36967 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5943_CAP Letter for Low Star ratings.pdf
H5985 - PHOENIX HEALTH PLANS, INC. | Tenet Healthcare Corporation |  |  | 36969 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5985_CAP Letter for Low Star ratings.pdf
H7811 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 36974 * | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H7811_CAP Letter for Low Star ratings.pdf
S5580 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 37002 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | S5580_CAP Letter for Low Star ratings.pdf
H3327 - TOUCHSTONE HEALTH HMO, INC. | Touchstone Health Partnership, Inc |  |  | 36915 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H3327_CAP Letter for Low Star ratings.pdf
H4213 - USABLE MUTUAL INSURANCE COMPANY | USAble Mutual Insurance Company | Customer Service | 8442014934 | 36962 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H4213_CAP Letter for Low Star ratings.pdf
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 36901 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0084_CAP Letter for Low Star ratings.pdf
H2111 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 36910 * | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H2111_CAP Letter for Low Star ratings.pdf
H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | UnitedHealth Group, Inc. |  |  | 36913 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H2905_CAP Letter for Low Star ratings.pdf
H3379 - UNITEDHEALTHCARE OF NEW YORK, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 36960 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H3379_CAP Letter for Low Star ratings.pdf
H3749 - UNITEDHEALTHCARE OF WISCONSIN, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 36961 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H3749_CAP Letter for Low Star ratings.pdf
H6528 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 36970 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H6528_CAP Letter for Low Star ratings.pdf
H7949 - PACIFICARE OF NEVADA, INC. | UnitedHealth Group, Inc. |  |  | 36975 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H7949_CAP Letter for Low Star ratings.pdf
R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 36979 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | R6801_CAP Letter for Low Star ratings.pdf
S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 37003 | 20-JUL-2015 | Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | S5921_CAP Letter for Low Star ratings.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 36921 | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H0913_CAP Letter for Low Star ratings.pdf
H1264 - WELLCARE OF TEXAS, INC. | WellCare Health Plans, Inc. |  |  | 36922 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H1264_CAP Letter for Low Star ratings.pdf
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. |  |  | 36926 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H1903_CAP Letter for Low Star ratings.pdf
H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 36978 | 20-JUL-2015 | Health and Drug Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H9730_CAP Letter for Low Star ratings.pdf
H5698 - HARMONY HEALTH PLAN, INC. | WellCare Health Plans, Inc. |  |  | 36983 * | 20-JUL-2015 | Health Benefit | Star Ratings | Organization's Star Rating score(s) established it as a poor performer, and CMS is requesting the organization develop and implement a corrective action plan designed to ensure that it will achieve at least an "average" star rating. | H5698_CAP Letter for Low Star ratings.pdf
H2354 - HEALTH ALLIANCE PLAN OF MICHIGAN | HealthPlus of Michigan | Heather Spencer | 2487763808 | 36201 | 15-JUL-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | ANOC EOC AdHocCap HealthPlus of MI H2354 (2015) REV.pdf
H5433 - ORANGE COUNTY HEALTH AUTHORITY | Orange County Health Authority | Customer Service | 8774122734 | 36202 | 15-JUL-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | ANOC EOC AdHocCap Orange Co Hlth Auth H5433 (2015) REV.pdf
H6743 - ATRIO HEALTH PLANS | ATRIO Health Plans | Customer Service | 8776728620 | 35630 | 29-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H6743 - Atrio CAP.pdf
H7006 - ATRIO HEALTH PLANS | ATRIO Health Plans | Customer Service | 8776728620 | 35460 | 18-MAY-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | ANOC EOC AdHocCap 2015 Atrio.pdf
H3660 - SUMMACARE INC. | Summa Health System | Donna Rank | 3309968400 | 35461 | 18-MAY-2015 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2015 Inaccurate ANOC/EOC | ANOC EOC AdHocCap 2015 Summacare.pdf
H3832 - HAWAII MEDICAL SERVICE ASSOCIATION | Hawaii Medical Service Association | Kevin Unger | 8089486186 | 35635 | 10-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H3832 HMSA.pdf
H3335 - EXCELLUS HEALTH PLAN, INC. H3351 - EXCELLUS HEALTH PLAN, INC. | Lifetime Healthcare, Inc. | Colleen Myrto | 3156718498 | 35636 | 10-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H3335-H3351 Lifetime Healthcare - Excellus.pdf
H4922 - AGEWELL NEW YORK, LLC | AgeWell New York, LLC |  |  | 35633 | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H4922 AgeWell New York.pdf
H3916 - HIGHMARK SENIOR HEALTH COMPANY H3957 - HIGHMARK CHOICE COMPANY H5106 - HIGHMARK SENIOR SOLUTIONS COMPANY | Highmark Health | Provider Service | 8665886967 | 35634 | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H3916-H3957-H5106 Highmark.pdf
H6609 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY | Humana Inc. | Lisa Richter | 8004486262 | 35632 | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. NOTE: CAP letter is dated May 5, 2015, and was emailed on May 8, 2015 | H6609-H8145 Humana.pdf
H9859 - MVP HEALTH PLAN, INC. | MVP Health Care, Inc. |  |  | 35631 * | 08-MAY-2015 | Drug Benefit | Bid Submission | This CAP deals with the failure to comply with CY2015 Part D bid submission requirements. In specific, the failure to offer a MAPD Basic offering. | H9859 MVP Health Plan Inc.pdf
H3152 - AETNA HEALTH INC. (NJ) H5521 - AETNA LIFE INSURANCE COMPANY H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY | Aetna Inc. | Aetna Customer Service | 8006240756 | 34380 | 26-FEB-2015 | Drug Benefit | Bid Submission | Failure to comply with CY2015 bid instructions. | CAP Aetna H3152 H5521 H7306 Aetna Feb 26 2015.pdf
H0318 - AETNA HEALTH, INC. (PA) H0523 - AETNA HEALTH OF CALIFORNIA INC. H0901 - AETNA HEALTH, INC. (PA) H1013 - COVENTRY HEALTH PLAN OF FLORIDA, INC. H1109 - AETNA HEALTH INC.(GA) H1419 - AETNA HEALTH, INC. (PA) H1608 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H1609 - AETNA HEALTH INC. (FL) H1692 - COVENTRY HEALTH CARE OF WEST VIRGINIA, INC. H2112 - AETNA HEALTH, INC. (PA) H2611 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H2663 - COVENTRY HEALTH CARE OF MISSOURI, INC H2667 - COVENTRY HEALTH CARE OF MISSOURI, INC H2672 - COVENTRY HEALTH CARE OF KANSAS, INC. H3152 - AETNA HEALTH INC. (NJ) H3312 - AETNA HEALTH INC. (NY) H3597 - AETNA HEALTH INC. (ME) H3623 - AETNA HEALTH, INC. (PA) H3928 - AETNA HEALTH INC. (LA) H3931 - AETNA HEALTH INC. (PA) H3959 - AETNA HEALTH INC. (PA) H4523 - AETNA HEALTH INC. (TX) H4910 - AETNA HEALTH, INC. (PA) H5048 - COVENTRY HEALTH CARE OF TEXAS, INC. H5302 - AETNA HEALTH INC. (GA) H5414 - AETNA HEALTH INC. (FL) H5509 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H5521 - AETNA LIFE INSURANCE COMPANY H5522 - AETNA LIFE INSURANCE COMPANY H5793 - AETNA HEALTH INC. (CT) H5813 - AETNA HEALTH, INC. (PA) H5832 - AETNA HEALTH, INC. (PA) H6560 - COVENTRY HEALTH CARE OF VIRGINIA, INC. H6923 - AETNA HEALTH, INC. (PA) H7149 - AETNA HEALTH INC. (PA) H7301 - COVENTRY HEALTH CARE OF ILLINOIS, INC. H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY H7908 - AETNA HEALTH, INC. (PA) H8393 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H8649 - AETNA HEALTH OF UTAH INC H8980 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY H9847 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY S5569 - CAMBRIDGE LIFE INSURANCE COMPANY S5674 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY S5768 - WELLCARE PRESCRIPTION INSURANCE, INC. S5810 - WELLCARE PRESCRIPTION INSURANCE, INC. | Aetna Inc. | Aetna Customer Service | 8002900190, 8005330367, 8006240756, 8667844916, 8667844918, 8669014692, 8883606626, 8883656052 | 34139 | 28-JAN-2015 | Drug Benefit | Access to Services--Pharmacies/Prescription Drug | Failure to adhere to Any Willing Pharmacy requirements, which resulted in substantial access issues at point of sale when beneficiaries, pharmacies, Aetna, and CMS were unclear on which pharmacies were included in the 2015 network. | AETNA CAP 01302015.pdf
H5969 - ALOHACARE | AlohaCare | AlohaCare Customer Service | 8089736395 | 33575 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | AlohaCare ANOC EOC CAP 12092014.pdf
H9302 - PREMERA BLUE CROSS | Catholic Health Initiatives |  |  | 33594 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | CatholicHealthInitiatives ANOC EOC CAP 120914.pdf
H5932 - GATEWAY HEALTH PLAN, INC. | Gateway Health, LLC. | Josh Hartman | 8006855209 | 33612 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | Gateway Health Plan ANOC EOC CAP 120914.pdf
H5050 - KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | Group Health Cooperative | Provider Assistance Unit | 8887674670 | 33613 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | Group Health Cooperative ANOC EOC CAP 120914.pdf
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., |  |  | 33634 | 09-DEC-2014 | Health and Drug Benefit | Marketing Materials--Advertising and Enrollment | CY 2014 Inaccurate ANOC/EOC | MolinaHealthCare ANOC EOC CAP 120914.pdf
H7149 - AETNA HEALTH INC. (PA) | Aetna Inc. | Aetna Customer Service | 8669014692 | 32633 | 07-AUG-2014 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2014 INACCURATE ANNUAL NOTICE OF CHANGE/EVIDENCE OF COVERAGE (ANOC/EOC) | Aetna ANOC EOC Ad Hoc Cap 080714.pdf
H1444 - TOTAL HEALTH CARE, INC. | Total Health Care, Inc. |  |  | 32634 * | 07-AUG-2014 | Health and Drug Benefit | Marketing--ANOC/EOC Errata Inaccuracies | CY 2014 INACCURATE ANNUAL NOTICE OF CHANGE/EVIDENCE OF COVERAGE (ANOC/EOC) | Total Health Care ANOC EOC Ad Hoc Cap 080714.pdf
H8393 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY | Aetna Inc. |  |  | 32019 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | Aetna ANOC EOC Ad Hoc Cap 053014.pdf
H2810 - GROUP HEALTH OPTIONS | Group Health Cooperative |  |  | 32020 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | Group Hlth Coop ANOC EOC Ad Hoc Cap 053014.pdf
R5826 - HUMANA INSURANCE COMPANY | Humana Inc. | Lisa Richter | 8004486262 | 32052 | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials | Humana ANOC EOC Ad Hoc Cap 053014.pdf
H4123 - MERCYCARE HMO, INC. | Mercy Alliance, Inc. |  |  | 32021 * | 30-MAY-2014 | Health and Drug Benefit | Marketing Materials--Member Communications | Corrective Action Required for inaccurate member materials\n | Mercy Alliance ANOC EOC Ad Hoc Cap 053014.pdf
H3907 - UPMC HEALTH PLAN, INC. H4279 - UPMC FOR YOU, INC H5533 - UPMC HEALTH NETWORK, INC. H9670 - UPMC HEALTH BENEFITS, INC. | UPMC Health System | Medicare Marketing | 8773813765 | 31912 | 28-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | OACT CAP - UPMC - 2014.pdf
H3923 - CAPITAL ADVANTAGE INSURANCE COMPANY H3962 - KEYSTONE HEALTH PLAN CENTRAL, INC. | CAPITAL BLUE CROSS | Gloria Yu | 8666882242 | 31774 | 21-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | OACT CAP - Capital BlueCross - 2014.pdf
S8067 - Avalon Insurance Company | CAPITAL BLUE CROSS | Gloria Yu | 8666882242 | 34721 | 21-MAY-2014 | Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 31774_n2wm_05212014163803139_1.OACT CAP - Capital BlueCross - 2014.pdf
H0028 - CHA HMO, INC. H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0248 - HUMANA INSURANCE COMPANY H0317 - HUMANA INSURANCE COMPANY H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1291 - HUMANA INSURANCE COMPANY OF NEW YORK H1406 - HUMANA HEALTH PLAN, INC. H1418 - HUMANA INSURANCE COMPANY H1468 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H1510 - HUMANA INSURANCE COMPANY H1681 - HUMANA INSURANCE COMPANY H1716 - HUMANA INSURANCE COMPANY H1906 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2486 - HUMANA MEDICAL PLAN OF UTAH, INC. H2542 - HUMANA INSURANCE COMPANY H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H3405 - HUMANA INSURANCE COMPANY H3533 - HUMANA HEALTH COMPANY OF NEW YORK, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4145 - HUMANA REGIONAL HEALTH PLAN, INC. H4408 - HUMANA INSURANCE COMPANY H4461 - CARITEN HEALTH PLAN INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H4520 - HUMANA INSURANCE COMPANY H4606 - HUMANA INSURANCE COMPANY H4956 - HUMANA INSURANCE COMPANY H5041 - HUMANA INSURANCE COMPANY H5214 - HUMANA INSURANCE COMPANY H5216 - HUMANA INSURANCE COMPANY H5291 - HUMANA HEALTH PLAN, INC. H5415 - HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. H5416 - ARCADIAN HEALTH PLAN, INC. H5525 - HUMANA BENEFIT PLAN OF ILLINOIS, INC. H5619 - ARCADIAN HEALTH PLAN, INC. H5868 - HUMANA INSURANCE COMPANY H5970 - HUMANA INSURANCE COMPANY OF NEW YORK H6411 - HUMANA INSURANCE COMPANY H6609 - HUMANA INSURANCE COMPANY H6622 - HUMANA WI HEALTH ORGANIZATION INSURANCE CORP H6859 - HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. H7002 - HUMANA INSURANCE COMPANY H7188 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY H8644 - HUMANA INSURANCE COMPANY H8707 - HUMANA INSURANCE COMPANY H8908 - HUMANA MEDICAL PLAN OF MICHIGAN, INC. H8953 - HUMANA HEALTH PLAN OF OHIO, INC. H9503 - HUMANA INSURANCE COMPANY R5826 - HUMANA INSURANCE COMPANY | Humana Inc. | Lisa Richter | 8004486262 | 31773 | 21-MAY-2014 | Health and Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | OACT CAP - HUMANA - 2014.pdf
S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. S5552 - HUMANA INSURANCE COMPANY OF NEW YORK S5884 - HUMANA INSURANCE COMPANY | Humana Inc. | Lisa Richter | 8004486262 | 34699 | 21-MAY-2014 | Drug Benefit | Bid Submission | This CAP concerns Actuarial Compliance with the CY2014 bid submission. | 31773_n2wm_05212014163603439_1.OACT CAP - HUMANA - 2014.pdf
H0901 - AETNA HEALTH, INC. (PA) | Aetna Inc. |  |  | 31537 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0901.pdf
H1109 - AETNA HEALTH INC.(GA) | Aetna Inc. | Aetna Customer Service | 8006240756 | 31541 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1109.pdf
H4523 - AETNA HEALTH INC. (TX) | Aetna Inc. | Aetna Customer Service | 8006240756 | 31572 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4523.pdf
H0979 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. | America's 1st Choice Holdings of N.C., LLC |  |  | 31539 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0979.pdf
H4268 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. | America's 1st Choice Holdings of N.C., LLC |  |  | 31570 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4268.pdf
H3421 - AMERICA'S 1ST CHOICE HEALTH PLANS, INC. | America's 1st Choice Holdings of S.C., LLC |  |  | 31557 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3421.pdf
H4738 - AMERICA'S 1ST CHOICE HEALTH PLANS, INC. | America's 1st Choice Holdings of S.C., LLC |  |  | 31573 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4738.pdf
S1480 - AULTCARE INSURANCE COMPANY | Aultman Health Foundation |  |  | 31612 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S1480.pdf
H4209 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | BlueCross BlueShield of South Carolina (BCBSSC) |  |  | 31569 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4209.pdf
S5601 - SILVERSCRIPT INSURANCE COMPANY | CVS Health Corporation | Kelly Devine | 8662355660 | 31614 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5601.pdf
H5430 - ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC. | Care1st Health Plan | Provider Services | 8662968731 | 31581 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5430.pdf
H6178 - CARESOURCE | CareSource |  |  | 31598 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H6178 (2).pdf
H6178 - CARESOURCE | CareSource |  |  | 31599 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H6178.pdf
H0908 - BUCKEYE COMMUNITY HEALTH PLAN, INC. | Centene Corporation | Provider Services | 8662968731 | 31538 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0908.pdf
H5294 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Member Services | 8779358023 | 31577 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5294.pdf
H5590 - Bridgeway Health Solutions of Arizona, Inc. | Centene Corporation | Provider Services | 8773915921 | 31587 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5590.pdf
H8189 - MANAGED HEALTH SERVICES INSURANCE CORP. | Centene Corporation | Provider Services | 8002229831 | 31605 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H8189.pdf
H4866 - CUATRO LLC | Cuatro LLC. |  |  | 31575 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4866.pdf
H5608 - DENVER HEALTH MEDICAL PLAN, INC. | Denver Health and Hospital Authority | HealthPlan Services | 3036022111 | 31588 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5608.pdf
H3347 - ELDERPLAN, INC. | Elderplan, Inc. | Doretha Alston | 7189217979 | 31555 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3347 (2).pdf
H3347 - ELDERPLAN, INC. | Elderplan, Inc. | Doretha Alston | 7189217979 | 31556 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3347.pdf
H3240 - AMERIGROUP NEW JERSEY, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 31552 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3240 (2).pdf
H3240 - AMERIGROUP NEW JERSEY, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 31553 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3240.pdf
H5896 - AMERIGROUP MARYLAND, INC. | Elevance Health, Inc. | Dedicated Services Unit | 8668054589 | 31596 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5896.pdf
H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | Elevance Health, Inc. |  |  | 31607 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H9947.pdf
S5960 - UNICARE LIFE & HEALTH INSURANCE COMPANY | Elevance Health, Inc. | Customer Service | 8882307338 | 31620 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5960.pdf
S7694 - ELIXIR INSURANCE COMPANY | Envision Topco Holdings, LLC | Customer Service | 8662502005 | 31621 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S7694.pdf
H3818 - FAMILYCARE HEALTH PLANS, INC. | FamilyCare Incorporated |  |  | 31558 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3818.pdf
H4011 - MMM HEALTHCARE, LLC | First Medical Health Plan, Inc. |  |  | 31565 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4011.pdf
H5887 - MMM HEALTHCARE, LLC. | First Medical Health Plan, Inc. |  |  | 31594 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5887 (2).pdf
H5887 - MMM HEALTHCARE, LLC. | First Medical Health Plan, Inc. |  |  | 31595 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5887.pdf
S5840 - FIRST MEDICAL HEALTH PLAN, INC. | First Medical Health Plan, Inc. |  |  | 31617 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5840.pdf
H6801 - GHS MANAGED HEALTH CARE PLANS, INC. | Health Care Service Corporation |  |  | 31600 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H6801.pdf
H5439 - HEALTH NET LIFE INSURANCE COMPANY | Health Net, Inc. | Provider Services | 8002754737 | 31582 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5439.pdf
H1681 - HUMANA INSURANCE COMPANY | Humana Inc. |  |  | 31546 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1681.pdf
H5416 - ARCADIAN HEALTH PLAN, INC. | Humana Inc. |  |  | 31580 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5416.pdf
H7188 - HUMANA INSURANCE COMPANY | Humana Inc. |  |  | 31602 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H7188.pdf
H5640 - IEHP HEALTH ACCESS | INLAND EMPIRE HEALTH PLAN |  |  | 31589 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5640.pdf
S2321 - QCC INSURANCE COMPANY | Independence Blue Cross |  |  | 31613 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S2321.pdf
H4003 - MMM HEALTHCARE, LLC | InnovaCare Inc. | Janice Quinones | 8666766060 | 31561 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4003.pdf
H4004 - MMM HEALTHCARE, LLC | InnovaCare Inc. | Janice Quinones | 8666766060 | 31562 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4004.pdf
H2643 - LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | Local Initiative Health Authority for LA County |  |  | 31549 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H2643.pdf
H4006 - MCS ADVANTAGE, INC. | Medical Card System, Inc. |  |  | 31564 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4006.pdf
H5580 - MERCY CARE | Mercy Care | Shannon Richardson | 6024535592 | 31585 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5580.pdf
H5471 - SIMPLY HEALTHCARE PLANS, INC. | Simply Healthcare Holdings, Inc. | Customer Service | 8882307338 | 31583 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5471.pdf
H5587 - HEALTH CHOICE ARIZONA, INC. | Steward Health Care System, LLC | Member Services | 8006568991 | 31586 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5587.pdf
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 31567 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4125.pdf
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 31568 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4125 (2).pdf
H7787 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group | Jared Rich | 8006683813 | 31603 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H7787.pdf
S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 31619 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5932.pdf
S5755 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 31615 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5755.pdf
H3327 - TOUCHSTONE HEALTH HMO, INC. | Touchstone Health Partnership, Inc |  |  | 31554 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3327.pdf
H4005 - TRIPLE S ADVANTAGE, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 31563 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4005.pdf
H4012 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 31566 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4012.pdf
H5732 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 31592 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5732.pdf
H5732 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 31593 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5732 (2).pdf
S5775 - TRIPLE S SALUD, INC. | Triple-S Management Corporation |  |  | 31616 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5775.pdf
S5907 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 31618 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_S5907.pdf
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 31532 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0084.pdf
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 31533 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0251.pdf
H0624 - UnitedHealthcare Benefits of Texas, Inc. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 31535 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0624.pdf
H1108 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 31540 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1108.pdf
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 31542 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1111.pdf
H1717 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 31547 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1717.pdf
H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | UnitedHealth Group, Inc. |  |  | 31550 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H2905.pdf
H3209 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 31551 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3209.pdf
H3887 - UNITEDHEALTHCARE OF THE MIDWEST, INC. | UnitedHealth Group, Inc. |  |  | 31559 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3887.pdf
H3921 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 31560 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H3921.pdf
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. |  |  | 31571 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4406.pdf
H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. | UnitedHealth Group, Inc. |  |  | 31574 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H4837.pdf
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC | UnitedHealth Group, Inc. |  |  | 31601 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H6952.pdf
H7949 - PACIFICARE OF NEVADA, INC. | UnitedHealth Group, Inc. |  |  | 31604 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H7949.pdf
H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. | UnitedHealth Group, Inc. |  |  | 31606 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H9011.pdf
R3444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 31608 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_R3444.pdf
R3444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 31609 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_R3444 (2).pdf
R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 31610 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_R6801.pdf
R9896 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 31611 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_R9896.pdf
H5378 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 31578 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5378 (2).pdf
H5378 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 31579 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5378.pdf
H6169 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 31597 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H6169.pdf
H0838 - UNIVERSAL CARE, INC. | Universal Care, Inc | Bright Health | 8442024463 | 31536 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0838.pdf
H5549 - VNS CHOICE | Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 31584 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5549.pdf
H0320 - WELLCARE OF TEXAS, INC. | WellCare Health Plans, Inc. |  |  | 31534 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H0320.pdf
H1112 - WELLCARE OF GEORGIA, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 31543 | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1112.pdf
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. | WellCare Health Plans, Inc. |  |  | 31544 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1216.pdf
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. | WellCare Health Plans, Inc. |  |  | 31545 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1216 (2).pdf
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. |  |  | 31548 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H1903.pdf
H5087 - WELLCARE OF CALIFORNIA, INC. | WellCare Health Plans, Inc. | Provider Services | 8662968731 | 31576 | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5087.pdf
H5698 - HARMONY HEALTH PLAN, INC. | WellCare Health Plans, Inc. |  |  | 31590 * | 17-APR-2014 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5698.pdf
H5698 - HARMONY HEALTH PLAN, INC. | WellCare Health Plans, Inc. |  |  | 31591 * | 17-APR-2014 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2014. | Low Star Rating CAP_H5698 (2).pdf
H0117 - WELLCARE OF OHIO, INC. H0320 - WELLCARE OF TEXAS, INC. H0712 - WELLCARE OF CONNECTICUT, INC. H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. H1032 - Sunshine State Health Plan, Inc. H1112 - WELLCARE OF GEORGIA, INC. H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. H1264 - WELLCARE OF TEXAS, INC. H1416 - HARMONY HEALTH PLAN, INC. H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H3361 - WELLCARE OF NEW YORK, INC. H9730 - WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 30830 | 27-FEB-2014 | Drug Benefit | Plan Finder Data | Sponsor contracts listed abovefailured to comply with Part D requirements concerning the representation of its contracted pharmacy network in its marketing materials and in reports to CMS for use in populating the Medicare Plan Finder (MPF). | WellCarePartDPharmacyCAP022714.pdf
S7694 - ELIXIR INSURANCE COMPANY | Envision Pharmaceutical Holdings, Inc. | Customer Service | 8662502005 | 31027 | 31-DEC-2013 | Drug Benefit | Formulary Submission and Administration | Failure to appropriately implement a fomlary transition policy. Failed to meet the threshold for both CY2012 and CY2013 | S7694_Envision_TMPA CAP TM.pdf
H5587 - HEALTH CHOICE ARIZONA, INC. | Steward Health Care System, LLC | Member Services | 8006568991 | 30572 | 31-DEC-2013 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 4RxCAP_Letter_H5587.pdf
S5755 - SILVERSCRIPT INSURANCE COMPANY | Torchmark Corporation |  |  | 30571 * | 31-DEC-2013 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | 4RxCAP_Letter_S5755.pdf
S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. | WellCare Health Plans, Inc. |  |  | 31028 * | 31-DEC-2013 | Drug Benefit | Formulary Submission and Administration | Failure to appropriately implement a fomlary transition policy. Failed to meet the threshold for both CY2012 and CY2013 | S5967_WellCare_TMPA_CAP TM.pdf
H4005 - TRIPLE S ADVANTAGE, INC. H4012 - TRIPLE-S SALUD, INC. H5732 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 30282 | 26-DEC-2013 | Health Benefit | Other | Triple S failed to comply with Part C requirements related to the credentialing and re-credentialing of contracted providers. | TRIPLE S CRED CAP12262013.pdf
H5928 - California Physicians' Service | Care1st Health Plan | Member Services | 8007764466 | 28822 | 30-AUG-2013 | Drug Benefit | Plan Corrections | Care1st received this CAP for requesting and needing to implement signficant changes in the Plan Corrections arena. | Care1st - CAP FINAL Email Ready.pdf
H9003 - KAISER FOUNDATION HP OF THE N W | Kaiser Foundation Health Plan, Inc. | Member Services | 8772218221 | 27789 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | Kaiser_ANOC_EOC_CAP.pdf
H5577 - MCS ADVANTAGE, INC. | Medical Card System, Inc. | Ivette Rodriguez | 7877582500 | 27786 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | Med Card System_ANOC_EOC_CAP.pdf
H3810 - ALLCARE HEALTH PLAN, INC. | MidRogue AllCare Health Assurance, Inc. | Nicole LaFond | 8884600185 | 27783 | 02-JUL-2013 | Health and Drug Benefit | Marketing Materials--Member Communications | Inaccurate ANOC/EOC Documents | Mid Rogue CHP_ANOC_EOC_CAP.pdf
H0108 - HUMANA HEALTH PLAN OF CALIFORNIA, INC. H0317 - HUMANA INSURANCE COMPANY H0623 - HUMANA INSURANCE COMPANY H1019 - CAREPLUS HEALTH PLANS, INC. H1036 - HUMANA MEDICAL PLAN, INC. H1406 - HUMANA HEALTH PLAN, INC. H1716 - HUMANA INSURANCE COMPANY H1951 - HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H2012 - HUMANA HEALTH PLAN, INC. H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. H2649 - HUMANA HEALTH PLAN, INC. H2944 - HUMANA INSURANCE COMPANY H2949 - HUMANA HEALTH PLAN, INC. H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4141 - HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4510 - HUMANA HEALTH PLAN OF TEXAS, INC. H4606 - HUMANA INSURANCE COMPANY H5291 - HUMANA HEALTH PLAN, INC. H5416 - ARCADIAN HEALTH PLAN, INC. H5426 - HUMANA ADVANTAGECARE PLAN, INC. H5868 - HUMANA INSURANCE COMPANY H6609 - HUMANA INSURANCE COMPANY H7188 - HUMANA INSURANCE COMPANY H8145 - HUMANA INSURANCE COMPANY H8644 - HUMANA INSURANCE COMPANY R5826 - HUMANA INSURANCE COMPANY S2874 - HUMANA INSURANCE OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 27202 | 06-MAY-2013 | Health and Drug Benefit | Bid Submission | Humana recieved this CAP due to various actuarial compliance issues regarding their bid submission. | Humana OACT CAP FINAL EMAIL READY.pdf
H0117 - WELLCARE OF OHIO, INC. H0320 - WELLCARE OF TEXAS, INC. H0712 - WELLCARE OF CONNECTICUT, INC. H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. H1112 - WELLCARE OF GEORGIA, INC. H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. H1264 - WELLCARE OF TEXAS, INC. H1416 - HARMONY HEALTH PLAN, INC. H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H3361 - WELLCARE OF NEW YORK, INC. S5967 - WELLCARE PRESCRIPTION INSURANCE, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 27542 | 24-APR-2013 | Health and Drug Benefit | Access to Services--Pharmacies/Prescription Drug, Call Center Requirements | WellCare failed to meet its internal performance standards regarding access to mail order pharmacy. In addition WellCare failed to meet CMS' call center requirements. CMS is requesting a corrective action plan to address the identified instances of non-compliance. | NONC-CAP Request_call center and mail order.pdf
S0064 - MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT OF NY | RCGM, LLC |  |  | 26182 * | 26-FEB-2013 | Drug Benefit | Call Center Requirements, Oversight and Management Capabilities | Corrective Action Plan request for failure to operate a customer service call center that provides customer telephone service as well as failing to exercise oversight and control of the call center. This request is a result of the organization not having an operational toll-free customer service telephone number at the beginning of the year and its management’s lack of awareness of this as and the resulting complaints from beneficiaries. | b5ws_02262013134833834_1.SmartD_Rx_CAP_Request_Call_Center_2013_.pdf
H0544 - BLUE CROSS OF CALIFORNIA | Elevance Health, Inc. | Customer Service | 8882307338 | 25410 | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | m5nx_01092013111623297_1.2013 4RxCAP H0544.pdf
S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25408 * | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | m5nx_01092013111232945_1.2013 4RxCAP S5932.pdf
H7281 - BRAVO HEALTH PENNSYLVANIA, INC. | The Cigna Group |  |  | 25409 * | 28-DEC-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Plan sponsor failed to submit 4Rx data for CMS generated enrollments in a timely manner. | m5nx_01092013111359011_1.2013 4RxCAP H7281.pdf
S5904 - BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. | Blue Cross and Blue Shield of Florida | Medicare Mbr Svcs | 8009266565 | 24954 | 19-DEC-2012 | Drug Benefit | Bid Submission | Actuarial deficiencies regarding bid submission. | n2wm_12192012103146806_1.BCBS Florida OACT Letter - Final Version- Email Ready.pdf
H3240 - AMERIGROUP NEW JERSEY, INC. | AMERIGROUP Corporation | Customer Service | 8882307338 | 25004 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25004_12192012135612823.LT32013_H3240C.pdf
H3240 - AMERIGROUP NEW JERSEY, INC. | AMERIGROUP Corporation | Customer Service | 8882307338 | 25005 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25005_12192012135612823.LT32013_H3240.pdf
H5746 - AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. | AMERIGROUP Corporation |  |  | 25084 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25084_12192012135612823.LT32013_H5746.pdf
H5817 - AMERIGROUP TEXAS, INC. | AMERIGROUP Corporation |  |  | 25088 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25088_12192012135612823.LT32013_H5817.pdf
H5896 - AMERIGROUP MARYLAND, INC. | AMERIGROUP Corporation | Dedicated Services Unit | 8668054589 | 25090 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25090_12192012135612823.LT32013_H5896.pdf
H6181 - AMERIGROUP NEW YORK, LLC | AMERIGROUP Corporation |  |  | 25092 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25092_12192012135612823.LT32013_H6181.pdf
H7200 - AMERIGROUP TENNESSEE, INC. | AMERIGROUP Corporation |  |  | 25095 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25095_12192012135612823.LT32013_H7200.pdf
H8991 - AMERIGROUP FLORIDA, INC. | AMERIGROUP Corporation |  |  | 25100 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25100_12192012135612823.LT32013_H8991.pdf
H8822 - ADVANTAGE HEALTH SOLUTIONS, INC. | Advantage Health Solutions |  |  | 24992 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24992_12192012135612823.LT3_2013_H8822.pdf
H5969 - ALOHACARE | AlohaCare | AlohaCare Customer Service | 8089736395 | 24978 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24978_12192012135612823.LT3_2013_H5969.pdf
H4268 - AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. | America's 1st Choice Holdings of N.C., LLC |  |  | 24988 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24988_12192012135612823.LT3_2013_H4268.pdf
S0043 - PREFERRED MEDICARE CHOICE, INC. | Aveta Inc. |  |  | 25104 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25104_12192012135612823.LT32013_S0043.pdf
S5937 - LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY | BlueCross BlueShield of Louisiana |  |  | 25111 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25111_12192012135612823.LT32013_S5937.pdf
H4209 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | BlueCross BlueShield of South Carolina (BCBSSC) |  |  | 25067 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25067_12192012135612823.LT32013_H4209.pdf
S5953 - BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | BlueCross BlueShield of South Carolina (BCBSSC) | Provider Services | 8003342583 | 25112 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25112_12192012135612823.LT32013_S5953.pdf
H5884 - BLUECROSS BLUESHIELD OF TENNESSEE | BlueCross BlueShield of Tennessee | Carol Troxell | 8008417434 | 24990 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24990_12192012135612823.LT3_2013_H5884.pdf
H6178 - CARESOURCE | CareSource |  |  | 25091 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25091_12192012135612823.LT32013_H6178.pdf
H5590 - Bridgeway Health Solutions of Arizona, Inc. | Centene Corporation | Provider Services | 8773915921 | 25041 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25041_12192012135612823.LT32013_H5590.pdf
H5294 - SUPERIOR HEALTHPLAN, INC. | Centene Corporation | Member Services | 8779358023 | 25072 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25072_12192012135612823.LT32013_H5294.pdf
H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. | Central Health Plan of California | Marketing Department | 6263882390 | 25042 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25042_12192012135612823.LT32013_H5649.pdf
H0621 - COLORADO ACCESS | Colorado Access |  |  | 24964 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24964_12192012135612823.LT3_2013_H0621.pdf
S5857 - PRIORITY HEALTH INSURANCE COMPANY | Corewell Health | Customer Service | 8883896648 | 24981 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24981_12192012135612823.LT3_2013_S5857.pdf
H2611 - COVENTRY HEALTH AND LIFE INSURANCE COMPANY | Coventry Health Care Inc. |  |  | 25061 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25061_12192012135612823.LT32013_H2611.pdf
H5302 - AETNA HEALTH INC. (GA) | Coventry Health Care Inc. | Aetna Customer Service | 8006240756 | 25073 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25073_12192012135612823.LT32013_H5302.pdf
H7306 - FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY | Coventry Health Care Inc. |  |  | 25096 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25096_12192012135612823.LT32013_H7306.pdf
H5608 - DENVER HEALTH MEDICAL PLAN, INC. | Denver Health and Hospital Authority | HealthPlan Services | 3036022111 | 24974 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24974_12192012135612823.LT3_2013_H5608.pdf
H3347 - ELDERPLAN, INC. | Elderplan, Inc. | Doretha Alston | 7189217979 | 24970 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24970_12192012135612823.LT3_2013_H3347.pdf
H1607 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 25055 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25055_12192012135612823.LT32013_H1607.pdf
H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. | Elevance Health, Inc. |  |  | 25057 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25057_12192012135612823.LT32013_H1849.pdf
H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. | Elevance Health, Inc. |  |  | 25077 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25077_12192012135612823.LT32013_H5530.pdf
S5960 - UNICARE LIFE & HEALTH INSURANCE COMPANY | Elevance Health, Inc. | Customer Service | 8882307338 | 25113 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25113_12192012135612823.LT32013_S5960.pdf
H4011 - MMM HEALTHCARE, LLC | First Medical Health Plan, Inc. |  |  | 25010 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25010_12192012135612823.LT32013_H4011C.pdf
H4011 - MMM HEALTHCARE, LLC | First Medical Health Plan, Inc. |  |  | 25011 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25011_12192012135612823.LT32013_H4011.pdf
H5887 - MMM HEALTHCARE, LLC. | First Medical Health Plan, Inc. |  |  | 25026 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25026_12192012135612823.LT32013_H5887C.pdf
H5887 - MMM HEALTHCARE, LLC. | First Medical Health Plan, Inc. |  |  | 25027 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25027_12192012135612823.LT32013_H5887.pdf
S5840 - FIRST MEDICAL HEALTH PLAN, INC. | First Medical Health Plan, Inc. |  |  | 25108 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25108_12192012135612823.LT32013_S5840.pdf
H7015 - HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. | HF Management Services, LLC |  |  | 25044 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25044_12192012135612823.LT32013_H7015.pdf
H5685 - HAP MIDWEST HEALTH PLAN, INC. | Henry Ford Health System |  |  | 25081 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25081_12192012135612823.LT32013_H5685.pdf
H5416 - ARCADIAN HEALTH PLAN, INC. | Humana Inc. |  |  | 24973 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24973_12192012135612823.LT3_2013_H5416.pdf
H0320 - WELLCARE OF TEXAS, INC. | Humana Inc. |  |  | 24982 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24982_12192012135612823.LT3_2013_H0320.pdf
H5041 - HUMANA INSURANCE COMPANY | Humana Inc. |  |  | 24989 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24989_12192012135612823.LT3_2013_H5041.pdf
H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 24998 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24998_12192012135612823.LT32013_H2029C.pdf
H2029 - HUMANA INSURANCE OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 24999 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24999_12192012135612823.LT32013_H2029.pdf
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. | Humana Inc. |  |  | 25000 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25000_12192012135612823.LT32013_H2899C.pdf
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. | Humana Inc. |  |  | 25001 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25001_12192012135612823.LT32013_H2899.pdf
H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 25008 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25008_12192012135612823.LT32013_H4007C.pdf
H4007 - HUMANA HEALTH PLANS OF PUERTO RICO, INC. | Humana Inc. | Lisa Richter | 8004486262 | 25009 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25009_12192012135612823.LT32013_H4007.pdf
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. | Humana Inc. |  |  | 25020 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25020_12192012135612823.LT32013_H5578C.pdf
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. | Humana Inc. |  |  | 25021 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25021_12192012135612823.LT32013_H5578.pdf
H5700 - ARKANSAS COMMUNITY CARE, INC. | Humana Inc. |  |  | 25022 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25022_12192012135612823.LT32013_H5700C.pdf
H5700 - ARKANSAS COMMUNITY CARE, INC. | Humana Inc. |  |  | 25023 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25023_12192012135612823.LT32013_H5700.pdf
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. | Humana Inc. |  |  | 25030 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25030_12192012135612823.LT32013_H7179C.pdf
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. | Humana Inc. |  |  | 25031 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25031_12192012135612823.LT32013_H7179.pdf
H4125 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | Humana Inc. |  |  | 25040 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25040_12192012135612823.LT32013_H4125.pdf
H6411 - HUMANA INSURANCE COMPANY | Humana Inc. |  |  | 25043 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25043_12192012135612823.LT32013_H6411.pdf
H5783 - ARCADIAN HEALTH PLAN, INC. | Humana Inc. |  |  | 25086 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25086_12192012135612823.LT32013_H5783.pdf
H7731 - MD CARE, INC. | Humana Inc. |  |  | 25118 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25118_12192012135612823.LT32013_H7731C.pdf
H7731 - MD CARE, INC. | Humana Inc. |  |  | 25119 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25119_12192012135612823.LT32013_H7731.pdf
H3337 - LIBERTY HEALTH ADVANTAGE, INC. | Liberty Health Advantage, Inc. |  |  | 25038 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25038_12192012135612823.LT32013_H3337.pdf
H2643 - LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | Local Initiative Health Authority for LA County |  |  | 25036 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25036_12192012135612823.LT32013_H2643.pdf
H5821 - MAPFRE LIFE INSURANCE COMPANY | MAPFRE PRAICO CORPORATION | Edgardo Silva | 7872506500 | 25089 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25089_12192012135612823.LT32013_H5821.pdf
H0141 - MCLAREN HEALTH PLAN, INC. | McLaren Health Care Corporation |  |  | 24963 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24963_12192012135612823.LT3_2013_H0141.pdf
H4006 - MCS ADVANTAGE, INC. | Medical Card System, Inc. |  |  | 25065 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25065_12192012135612823.LT32013_H4006.pdf
H5577 - MCS ADVANTAGE, INC. | Medical Card System, Inc. | Ivette Rodriguez | 7877582500 | 25079 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25079_12192012135612823.LT32013_H5577.pdf
S5555 - MCS ADVANTAGE, INC. | Medical Card System, Inc. |  |  | 25106 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25106_12192012135612823.LT32013_S5555.pdf
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. | Molina Healthcare, Inc., | Member Services | 8006651029 | 24957 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24957_12192012135612823.LT3_2013_H5823.pdf
H5823 - MOLINA HEALTHCARE OF WASHINGTON, INC. | Molina Healthcare, Inc., | Member Services | 8006651029 | 24958 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24958_12192012135612823.LT3_2013_H5823C.pdf
H5628 - MOLINA HEALTHCARE OF UTAH, INC. | Molina Healthcare, Inc., | Member Services | 8886651328 | 24975 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24975_12192012135612823.LT3_2013_H5628.pdf
H5926 - MOLINA HEALTHCARE OF MICHIGAN, INC. | Molina Healthcare, Inc., | Member Services | 8006653072 | 24976 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24976_12192012135612823.LT3_2013_H5926.pdf
H5810 - MOLINA HEALTHCARE OF CALIFORNIA | Molina Healthcare, Inc., | Member Services | 8006650898 | 25087 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25087_12192012135612823.LT32013_H5810.pdf
H7678 - MOLINA HEALTHCARE OF TEXAS, INC. | Molina Healthcare, Inc., | Member Services | 8664400012 | 25098 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25098_12192012135612823.LT32013_H7678.pdf
H8130 - MOLINA HEALTHCARE OF FLORIDA, INC. | Molina Healthcare, Inc., |  |  | 25099 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25099_12192012135612823.LT32013_H8130.pdf
H9082 - MOLINA HEALTHCARE OF NEW MEXICO, INC. | Molina Healthcare, Inc., |  |  | 25102 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25102_12192012135612823.LT32013_H9082.pdf
H5162 - STERLING LIFE INSURANCE COMPANY | Munich American Holding Corporation |  |  | 24972 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24972_12192012135612823.LT3_2013_H5162.pdf
H3410 - STERLING LIFE INSURANCE COMPANY | Munich American Holding Corporation |  |  | 24986 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24986_12192012135612823.LT3_2013_H3410.pdf
H5006 - STERLING LIFE INSURANCE COMPANY | Munich American Holding Corporation |  |  | 25071 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25071_12192012135612823.LT32013_H5006.pdf
H5698 - HARMONY HEALTH PLAN, INC. | Munich American Holding Corporation |  |  | 25082 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25082_12192012135612823.LT32013_H5698.pdf
S2505 - HARMONY HEALTH PLAN, INC. | Munich American Holding Corporation |  |  | 25105 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25105_12192012135612823.LT32013_S2505.pdf
H0423 - METROPLUS HEALTH PLAN, INC. | New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 25050 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25050_12192012135612823.LT32013_H0423.pdf
S5775 - TRIPLE S SALUD, INC. | Pharmacy Insurance Corporation of America |  |  | 25107 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25107_12192012135612823.LT32013_S5775.pdf
H4155 - PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY | Public Health Trust of Miami-Dade County |  |  | 24987 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24987_12192012135612823.LT3_2013_H4155.pdf
H5943 - SCAN HEALTH PLAN | SCAN Health Plan | Kim McBeath | 8777787226 | 24977 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24977_12192012135612823.LT3_2013_H5943.pdf
H9385 - SCAN HEALTH PLAN ARIZONA | SCAN Health Plan |  |  | 24980 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24980_12192012135612823.LT3_2013_H9385.pdf
H2165 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 24968 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24968_12192012135612823.LT3_2013_H2165.pdf
H7281 - BRAVO HEALTH PENNSYLVANIA, INC. | The Cigna Group |  |  | 25032 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25032_12192012135612823.LT32013_H7281C.pdf
H7281 - BRAVO HEALTH PENNSYLVANIA, INC. | The Cigna Group |  |  | 25033 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25033_12192012135612823.LT32013_H7281.pdf
H0150 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY | The Cigna Group |  |  | 25047 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25047_12192012135612823.LT32013_H0150.pdf
H1355 - BRAVO HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25054 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25054_12192012135612823.LT32013_H1355.pdf
H2108 - BRAVO HEALTH MID-ATLANTIC, INC. | The Cigna Group | Jared Rich | 8006683813 | 25059 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25059_12192012135612823.LT32013_H2108.pdf
H3964 - BRAVO HEALTH PENNSYLVANIA, INC. | The Cigna Group |  |  | 25063 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25063_12192012135612823.LT32013_H3964.pdf
H4407 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group | Jared Rich | 8006683813 | 25068 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25068_12192012135612823.LT32013_H4407.pdf
S5932 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25110 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25110_12192012135612823.LT32013_S5932.pdf
S5998 - BRAVO HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25114 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25114_12192012135612823.LT32013_S5998.pdf
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25116 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25116_12192012135612823.LT32013_H4528C.pdf
H4528 - HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | The Cigna Group |  |  | 25117 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25117_12192012135612823.LT32013_H4528.pdf
H3328 - THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. | The New York State Catholic Health Plan, Inc. |  |  | 25062 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25062_12192012135612823.LT32013_H3328.pdf
H7352 - UNIVERSITY CARE ADVANTAGE, LLC | The University of AZ Health Network, Inc. |  |  | 25097 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25097_12192012135612823.LT32013_H7352.pdf
H3327 - TOUCHSTONE HEALTH HMO, INC. | Touchstone Health Partnership, Inc |  |  | 25037 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25037_12192012135612823.LT32013_H3327.pdf
H1846 - MOUNT CARMEL HEALTH INSURANCE COMPANY | Trinity Health Corporation | Patricia Suffern | 4124780244 | 24967 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24967_12192012135612823.LT3_2013_H1846.pdf
H4005 - TRIPLE S ADVANTAGE, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 25064 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25064_12192012135612823.LT32013_H4005.pdf
H4012 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 25066 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25066_12192012135612823.LT32013_H4012.pdf
H5732 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 25083 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25083_12192012135612823.LT32013_H5732.pdf
H5774 - TRIPLE S ADVANTAGE, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 25085 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25085_12192012135612823.LT32013_H5774.pdf
S5907 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 25109 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25109_12192012135612823.LT32013_S5907.pdf
H9670 - UPMC HEALTH BENEFITS, INC. | UPMC Health System |  |  | 24993 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24993_12192012135612823.LT3_2013_H9670.pdf
H4213 - USABLE MUTUAL INSURANCE COMPANY | USAble Mutual Insurance Company | Customer Service | 8442014934 | 24971 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24971_12192012135612823.LT3_2013_H4213.pdf
H0624 - UnitedHealthcare Benefits of Texas, Inc. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 24965 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24965_12192012135612823.LT3_2013_H0624.pdf
H3107 - OXFORD HEALTH PLANS (NJ), INC. | UnitedHealth Group, Inc. |  |  | 24985 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24985_12192012135612823.LT3_2013_H3107.pdf
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 24994 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24994_12192012135612823.LT32013_H0251C.pdf
H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 24995 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24995_12192012135612823.LT32013_H0251.pdf
H3164 - AMERICHOICE OF NEW JERSEY, INC | UnitedHealth Group, Inc. |  |  | 25002 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25002_12192012135612823.LT32013_H3164C.pdf
H3164 - AMERICHOICE OF NEW JERSEY, INC | UnitedHealth Group, Inc. |  |  | 25003 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25003_12192012135612823.LT32013_H3164.pdf
H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 25006 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25006_12192012135612823.LT32013_H3387C.pdf
H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 25007 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25007_12192012135612823.LT32013_H3387.pdf
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. |  |  | 25012 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25012_12192012135612823.LT32013_H4406C.pdf
H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | UnitedHealth Group, Inc. |  |  | 25013 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25013_12192012135612823.LT32013_H4406.pdf
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC | UnitedHealth Group, Inc. |  |  | 25028 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25028_12192012135612823.LT32013_H6952C.pdf
H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC | UnitedHealth Group, Inc. |  |  | 25029 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25029_12192012135612823.LT32013_H6952.pdf
H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. | UnitedHealth Group, Inc. |  |  | 25039 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25039_12192012135612823.LT32013_H3920.pdf
R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | UnitedHealth Group, Inc. |  |  | 25045 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25045_12192012135612823.LT32013_R5674.pdf
H0084 - CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 25046 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25046_12192012135612823.LT32013_H0084.pdf
H0151 - UNITEDHEALTHCARE OF ALABAMA, INC. | UnitedHealth Group, Inc. |  |  | 25048 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25048_12192012135612823.LT32013_H0151.pdf
H0321 - ARIZONA PHYSICIANS IPA, INC. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 25049 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25049_12192012135612823.LT32013_H0321.pdf
H1108 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 25051 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25051_12192012135612823.LT32013_H1108.pdf
H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 25052 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25052_12192012135612823.LT32013_H1111.pdf
H1717 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 25056 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25056_12192012135612823.LT32013_H1717.pdf
H2182 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 25060 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25060_12192012135612823.LT32013_H2182.pdf
H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 25069 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25069_12192012135612823.LT32013_H4514.pdf
H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. | UnitedHealth Group, Inc. |  |  | 25070 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25070_12192012135612823.LT32013_H4837.pdf
H5407 - CITRUS HEALTH CARE, INC. | UnitedHealth Group, Inc. |  |  | 25075 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25075_12192012135612823.LT32013_H5407.pdf
H5440 - UNITEDHEALTHCARE INSURANCE COMPANY | UnitedHealth Group, Inc. |  |  | 25076 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25076_12192012135612823.LT32013_H5440.pdf
H6528 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 25093 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25093_12192012135612823.LT32013_H6528.pdf
H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. | UnitedHealth Group, Inc. |  |  | 25101 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25101_12192012135612823.LT32013_H9011.pdf
R6801 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 25103 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25103_12192012135612823.LT32013_R6801.pdf
R9896 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | UnitedHealth Group, Inc. |  |  | 25115 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25115_12192012135612823.LT32013_R9896.pdf
H6169 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 24959 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24959_12192012135612823.LT3_2013_H6169C.pdf
H6169 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 24960 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24960_12192012135612823.LT3_2013_H6169.pdf
H5378 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 25014 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25014_12192012135612823.LT32013_H5378C.pdf
H5378 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 25015 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25015_12192012135612823.LT32013_H5378.pdf
H5421 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 25016 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25016_12192012135612823.LT32013_H5421C.pdf
H5421 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 25017 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25017_12192012135612823.LT32013_H5421.pdf
H5656 - SELECTCARE HEALTH PLANS, INC. | Universal American Corp. |  |  | 25080 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25080_12192012135612823.LT32013_H5656.pdf
H0838 - UNIVERSAL CARE, INC. | Universal Care, Inc | Bright Health | 8442024463 | 24983 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24983_12192012135612823.LT3_2013_H0838.pdf
H8098 - UNIVERSAL HEALTH CARE INSURANCE COMPANY | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24961 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24961_12192012135612823.LT3_2013_H8098.pdf
H8098 - UNIVERSAL HEALTH CARE INSURANCE COMPANY | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24962 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24962_12192012135612823.LT3_2013_H8098C.pdf
H6705 - UNIVERSAL HEALTH CARE OF NEVADA, INC. | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 24979 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24979_12192012135612823.LT3_2013_H6705.pdf
H5429 - UNIVERSAL HEALTH CARE, INC. | Universal Health Care Group, Inc. |  |  | 25018 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25018_12192012135612823.LT32013_H5429C.pdf
H5429 - UNIVERSAL HEALTH CARE, INC. | Universal Health Care Group, Inc. |  |  | 25019 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25019_12192012135612823.LT32013_H5429.pdf
H5820 - UNIVERSAL HEALTH CARE INSURANCE COMPANY | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25024 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25024_12192012135612823.LT32013_H5820C.pdf
H5820 - UNIVERSAL HEALTH CARE INSURANCE COMPANY | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25025 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25025_12192012135612823.LT32013_H5820.pdf
H5404 - UNIVERSAL HEALTH CARE, INC. | Universal Health Care Group, Inc. |  |  | 25074 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25074_12192012135612823.LT32013_H5404.pdf
H6642 - UNIVERSAL HMO OF TEXAS, INC. | Universal Health Care Group, Inc. | Francoise Culley-Trotman | 8666904842 | 25094 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25094_12192012135612823.LT32013_H6642.pdf
H5985 - PHOENIX HEALTH PLANS, INC. | Vanguard Health Systems |  |  | 24991 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24991_12192012135612823.LT3_2013_H5985.pdf
H5549 - VNS CHOICE | Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 25078 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25078_12192012135612823.LT32013_H5549.pdf
H3361 - WELLCARE OF NEW YORK, INC. | WellCare Health Plans, Inc. |  |  | 24955 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24955_12192012135612823.LT3_2013_H3361.pdf
H3361 - WELLCARE OF NEW YORK, INC. | WellCare Health Plans, Inc. |  |  | 24956 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24956_12192012135612823.LT3_2013_H3361C.pdf
H0712 - WELLCARE OF CONNECTICUT, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24966 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24966_12192012135612823.LT3_2013_H0712.pdf
H2491 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24969 | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24969_12192012135612823.LT3_2013_H2491.pdf
H1112 - WELLCARE OF GEORGIA, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 24984 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24984_12192012135612823.LT3_2013_H1112.pdf
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. | WellCare Health Plans, Inc. |  |  | 24996 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24996_12192012135612823.LT32013_H1216C.pdf
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. | WellCare Health Plans, Inc. |  |  | 24997 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 24997_12192012135612823.LT32013_H1216.pdf
H0117 - WELLCARE OF OHIO, INC. | WellCare Health Plans, Inc. |  |  | 25034 * | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25034_12192012135612823.LT32013_H0117.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 25035 | 13-DEC-2012 | Health Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25035_12192012135612823.LT32013_H0913.pdf
H1264 - WELLCARE OF TEXAS, INC. | WellCare Health Plans, Inc. |  |  | 25053 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25053_12192012135612823.LT32013_H1264.pdf
H1903 - WELLCARE HEALTH INSURANCE OF ARIZONA, INC. | WellCare Health Plans, Inc. |  |  | 25058 * | 13-DEC-2012 | Drug Benefit | Star Ratings | Organization achieved a less than 3 star plan rating for 2013. | 25058_12192012135612823.LT32013_H1903.pdf
H1016 - AVMED, INC. | AvMed, Inc. | Catherine Lojko | 3523728400 | 23570 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012112019275.SII_2012_H1016.pdf
H4152 - BLUE CROSS & BLUE SHIELD OF RHODE ISLAND | Blue Cross & Blue Shield of Rhode Island | Ivona Wisniewski | 4014591721 | 23995 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | b5ws_09242012150554217_1.SII_2012_H4152.pdf
S5937 - LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY | BlueCross BlueShield of Louisiana |  |  | 23999 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | b5ws_09242012151116236_1.SII_2012_S5937.pdf
H0571 - CHINESE COMMUNITY HEALTH PLAN | Chinese Hospital Association | Youngsoo Cho | 6282283375 | 23569 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012111846173.SII_2012_H0571.pdf
H5826 - COMMUNITY HEALTH PLAN OF WASHINGTON | Community Health Plan of Washington | Customer Care | 8009420247 | 23998 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | b5ws_09242012150937066_1.SII_2012_H5826.pdf
S5877 - EDUCATORS MUTUAL INSURANCE ASSOCIATION | Educators Mutual Insurance Association | Nathan Gedge | 8012702974 | 23577 | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012130232110.SII_2012_S5877.pdf
H5887 - MMM HEALTHCARE, LLC. | First Medical Health Plan, Inc. |  |  | 23574 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012125403109.SII_2012_H5887.pdf
S5840 - FIRST MEDICAL HEALTH PLAN, INC. | First Medical Health Plan, Inc. |  |  | 23576 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012130031674.SII_2012_S5840.pdf
H4011 - MMM HEALTHCARE, LLC | First Medical Health Plan, Inc. |  |  | 23599 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012121605091.SII_2012_H4011.pdf
H5821 - MAPFRE LIFE INSURANCE COMPANY | MAPFRE PRAICO CORPORATION | Edgardo Silva | 7872506500 | 23997 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet Interpreter Availability threshold in 2010, 2011 and 2012 | b5ws_09242012150741281_1.SII_2012_H5821.pdf
S5555 - MCS ADVANTAGE, INC. | Medical Card System, Inc. |  |  | 23575 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012125625185.SII_2012_S5555.pdf
H4006 - MCS ADVANTAGE, INC. | Medical Card System, Inc. |  |  | 23598 * | 16-AUG-2012 | Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012121418714.SII_2012_H4006.pdf
H2701 - NEW WEST HEALTH SERVICES | New West Health Services |  |  | 23571 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012112327708.SII_2012_H2701.pdf
H0423 - METROPLUS HEALTH PLAN, INC. | New York City Health and Hospitals Corporation | Kathryn Soman | 2129088588 | 23568 | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012111610656.SII_2012_H0423.pdf
H3327 - TOUCHSTONE HEALTH HMO, INC. | Touchstone Health Partnership, Inc |  |  | 23572 * | 16-AUG-2012 | Health and Drug Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012112535255.SII_2012_H3327.pdf
H4005 - TRIPLE S ADVANTAGE, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 23573 | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012112737435.SII_2012_H4005.pdf
H4012 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 23600 * | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012121913399.SII_2012_H4012.pdf
H5732 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 23601 * | 16-AUG-2012 | Health Benefit | Call Center Requirements | Failed to meet TTY service threshold in 2009, 2010, 2011 and 2012 | b5ws_09052012122047140.SII_2012_H5732.pdf
H0318 - AETNA HEALTH, INC. (PA) H0523 - AETNA HEALTH OF CALIFORNIA INC. H0901 - AETNA HEALTH, INC. (PA) H1109 - AETNA HEALTH INC.(GA) H1110 - AETNA LIFE INSURANCE COMPANY H1419 - AETNA HEALTH, INC. (PA) H2112 - AETNA HEALTH, INC. (PA) H3152 - AETNA HEALTH INC. (NJ) H3312 - AETNA HEALTH INC. (NY) H3597 - AETNA HEALTH INC. (ME) H3623 - AETNA HEALTH, INC. (PA) H3931 - AETNA HEALTH INC. (PA) H4523 - AETNA HEALTH INC. (TX) H4524 - AETNA LIFE INSURANCE COMPANY H4910 - AETNA HEALTH, INC. (PA) H5414 - AETNA HEALTH INC. (FL) H5521 - AETNA LIFE INSURANCE COMPANY H5793 - AETNA HEALTH INC. (CT) H5813 - AETNA HEALTH, INC. (PA) H5832 - AETNA HEALTH, INC. (PA) H5950 - AETNA HEALTH, INC. (PA) H6923 - AETNA HEALTH, INC. (PA) H7908 - AETNA HEALTH, INC. (PA) H8684 - AETNA LIFE INSURANCE COMPANY S5810 - WELLCARE PRESCRIPTION INSURANCE, INC. | Aetna Inc. | Aetna Customer Service | 8006240756 | 23401 | 19-JUL-2012 | Drug Benefit | Formulary Submission and Administration | Jan.-Mar. 2012 Audit of Aetna's formulary administration revealed significant compliance problems regarding formulary and benefit administration including transition policy implementation failures. | s2k1_08162012122327527.AetnaCAP-corrected-07192012.pdf
H0151 - UNITEDHEALTHCARE OF ALABAMA, INC. H0251 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H0303 - PACIFICARE OF ARIZONA, INC. H0316 - UNITEDHEALTHCARE OF ARIZONA, INC. H0319 - UNITEDHEALTHCARE INSURANCE COMPANY H0321 - ARIZONA PHYSICIANS IPA, INC. H0401 - UNITEDHEALTHCARE OF ARKANSAS, INC. H0408 - UNITEDHEALTHCARE INSURANCE COMPANY H0543 - UHC OF CALIFORNIA H0609 - UnitedHealthcare Benefits of Texas, Inc. H0620 - UNITEDHEALTHCARE INSURANCE COMPANY H0624 - UnitedHealthcare Benefits of Texas, Inc. H0710 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H0752 - OXFORD HEALTH PLANS (CT), INC. H0755 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H1080 - UNITEDHEALTHCARE OF FLORIDA, INC. H1108 - UNITEDHEALTHCARE INSURANCE COMPANY H1111 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H1286 - UNITEDHEALTHCARE OF OREGON, INC. H1303 - UNITEDHEALTHCARE INSURANCE COMPANY H1509 - UNITEDHEALTHCARE INSURANCE COMPANY H1717 - UNITEDHEALTHCARE INSURANCE COMPANY H1944 - UNITEDHEALTHCARE OF WISCONSIN, INC. H2001 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H2111 - UNITEDHEALTHCARE INSURANCE COMPANY H2182 - UNITEDHEALTHCARE INSURANCE COMPANY H2226 - UNITEDHEALTHCARE INSURANCE COMPANY H2228 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H2406 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H2654 - UNITEDHEALTHCARE OF THE MIDWEST, INC. H2802 - UNITEDHEALTHCARE OF THE MIDLANDS, INC. H2803 - UNITEDHEALTHCARE INSURANCE COMPANY H2905 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H2931 - HEALTH PLAN OF NEVADA, INC. H3107 - OXFORD HEALTH PLANS (NJ), INC. H3113 - OXFORD HEALTH PLANS (NJ), INC. H3164 - AMERICHOICE OF NEW JERSEY, INC H3209 - UNITEDHEALTHCARE INSURANCE COMPANY H3307 - OXFORD HEALTH PLANS (NY), INC. H3379 - UNITEDHEALTHCARE OF NEW YORK, INC. H3387 - UNITEDHEALTHCARE OF NEW YORK, INC. H3456 - UNITEDHEALTHCARE OF NORTH CAROLINA, INC. H3659 - UNITEDHEALTHCARE OF OHIO, INC. H3749 - UNITEDHEALTHCARE OF WISCONSIN, INC. H3805 - UnitedHealthcare Benefits of Texas, Inc. H3812 - UNITEDHEALTHCARE INSURANCE COMPANY H3887 - UNITEDHEALTHCARE OF THE MIDWEST, INC. H3912 - UNITEDHEALTHCARE INSURANCE COMPANY H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. H3921 - UNITEDHEALTHCARE INSURANCE COMPANY H4102 - UNITEDHEALTHCARE OF NEW ENGLAND, INC. H4406 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H4456 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. H4522 - UNITEDHEALTHCARE INSURANCE COMPANY H4527 - PHYSICIANS HEALTH CHOICE OF TEXAS, LLC H4590 - UNITEDHEALTHCARE BENEFITS OF TEXAS, INC. H4604 - UNITEDHEALTHCARE OF THE ROCKIES, INC. H4837 - UNITEDHEALTHCARE OF WISCONSIN, INC. H4971 - UNITEDHEALTHCARE INSURANCE COMPANY H5005 - UNITEDHEALTHCARE OF WASHINGTON, INC. H5008 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H5253 - UNITEDHEALTHCARE OF WISCONSIN, INC. H5407 - CITRUS HEALTH CARE, INC. H5417 - UNITEDHEALTHCARE INSURANCE COMPANY H5424 - UNITEDHEALTHCARE INSURANCE COMPANY H5435 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H5440 - UNITEDHEALTHCARE INSURANCE COMPANY H5507 - UNITEDHEALTHCARE INSURANCE COMPANY H5516 - UNITEDHEALTHCARE INSURANCE COMPANY H5532 - UNITEDHEALTHCARE INSURANCE COMPANY H5652 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H5749 - UNITEDHEALTHCARE INSURANCE COMPANY H5998 - UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H6952 - UNITEDHEALTHCARE COMMUNITY PLAN, INC H7187 - UNITEDHEALTHCARE OF WISCONSIN, INC. H7949 - PACIFICARE OF NEVADA, INC. H8748 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H9011 - UNITEDHEALTHCARE OF FLORIDA, INC. R3175 - UNITEDHEALTHCARE INSURANCE COMPANY R5287 - UNITEDHEALTHCARE INSURANCE COMPANY R5342 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. R7444 - CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. S5805 - UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK S5820 - UNITEDHEALTHCARE INSURANCE COMPANY S5921 - UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 22921 | 19-JUN-2012 | Drug Benefit | Formulary Submission and Administration | United failed to follow CMS requirements in regard to formulary and benefit administration. | s2k1_07092012160153424.United Corrective Action Plan Request 06-19-12.pdf
H1419 - AETNA HEALTH, INC. (PA) | Aetna Inc. |  |  | 23263 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012151933297.LPI_H1419.pdf
H4524 - AETNA LIFE INSURANCE COMPANY | Aetna Inc. |  |  | 23268 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012155516457.LPI_H4524.pdf
H5414 - AETNA HEALTH INC. (FL) | Aetna Inc. |  |  | 23269 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012161829836.LPI_H5414.pdf
H5649 - CENTRAL HEALTH PLAN OF CALIFORNIA, INC. | Central Health Plan of California | Marketing Department | 6263882390 | 23274 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012163753657.LPI_H5649.pdf
H7015 - HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. | HF Management Services, LLC |  |  | 23306 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012171605592.LPI_H7015.pdf
S3440 - ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | Health Alliance Plan (HAP) |  |  | 23309 * | 31-MAY-2012 | Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012173001622.LPI_S3440.pdf
H2899 - ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. | Humana Inc. |  |  | 23264 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012152541317.LPI_H2899.pdf
H5578 - ARCADIAN HEALTH PLAN OF GEORGIA, INC. | Humana Inc. |  |  | 23273 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012163453459.LPI_H5578.pdf
H5700 - ARKANSAS COMMUNITY CARE, INC. | Humana Inc. |  |  | 23303 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012170248796.LPI_H5700.pdf
H7179 - ARCADIAN HEALTH PLAN OF LOUISIANA, INC. | Humana Inc. |  |  | 23307 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012172306657.LPI_H7179.pdf
H7731 - MD CARE, INC. | Humana Inc. |  |  | 23308 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012172547760.LPI_H7731.pdf
H3337 - LIBERTY HEALTH ADVANTAGE, INC. | Liberty Health Advantage, Inc. |  |  | 23265 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012153210040.LPI_H3337.pdf
H5810 - MOLINA HEALTHCARE OF CALIFORNIA | Molina Healthcare, Inc., | Member Services | 8006650898 | 23305 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012171041326.LPI_H5810.pdf
H5698 - HARMONY HEALTH PLAN, INC. | Munich American Holding Corporation |  |  | 23302 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012165954152.LPI_H5698.pdf
H4012 - TRIPLE-S SALUD, INC. | Triple-S Management Corporation |  |  | 23267 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012155142282.LPI_H4012.pdf
H5774 - TRIPLE S ADVANTAGE, INC. | Triple-S Management Corporation | Zoraida Mendez | 7877494949 | 23304 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012170710989.LPI_H5774.pdf
H3164 - AMERICHOICE OF NEW JERSEY, INC | UnitedHealth Group, Inc. |  |  | 23141 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | b5i2_07262012160038425.LPI_H3164.pdf
H3920 - UNITEDHEALTHCARE OF PENNSYLVANIA, INC. | UnitedHealth Group, Inc. |  |  | 23142 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | b5i2_07262012160737275.LPI_H3920.pdf
R5674 - SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | UnitedHealth Group, Inc. |  |  | 23143 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | b5i2_07262012161112074.LPI_R5674.pdf
H5407 - CITRUS HEALTH CARE, INC. | UnitedHealth Group, Inc. |  |  | 23144 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | b5i2_07262012161339808.LPI_H5407.pdf
H4514 - UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. | UnitedHealth Group, Inc. | Mark Britton | 9529126668 | 23145 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | b5i2_07262012161520554.LPI_H4514.pdf
H3706 - GLOBALHEALTH, INC. | Universal American Corp. | Daniel Thomas | 4055261126 | 23266 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012154933798.LPI_H3706.pdf
H5421 - THE PYRAMID LIFE INSURANCE COMPANY | Universal American Corp. |  |  | 23270 * | 31-MAY-2012 | Health and Drug Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012162239548.LPI_H5421.pdf
H5656 - SELECTCARE HEALTH PLANS, INC. | Universal American Corp. |  |  | 23301 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012165432944.LPI_H5656.pdf
H5429 - UNIVERSAL HEALTH CARE, INC. | Universal Health Care Group, Inc. |  |  | 23271 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | b5i2_08062012163059347.LPI_H5429.pdf
H5549 - VNS CHOICE | Visiting Nurse Service of New York | Cindy Zanca | 8667831444 | 23272 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C and/or D summary rating of at least three stars for at least three consecutive years. | LPI_H5549.pdf
H0117 - WELLCARE OF OHIO, INC. | WellCare Health Plans, Inc. |  |  | 23261 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | LPI_H0117.pdf
H1216 - HARMONY HEALTH PLAN OF ILLINOIS, INC. | WellCare Health Plans, Inc. |  |  | 23262 * | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | LPI_H1216.pdf
H0913 - WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | WellCare Health Plans, Inc. | Website Inquiries | 8888889355 | 23281 | 31-MAY-2012 | Health Benefit | Star Ratings | The organization has failed to achieve a Part C or D summary rating of at least three stars for at least three consecutive years. | LPI_H0913.pdf
H0564 - BLUE CROSS OF CALIFORNIA H1517 - ANTHEM INSURANCE COMPANIES, INC. H1607 - ANTHEM INSURANCE COMPANIES, INC. H1849 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. H2836 - ANTHEM HEALTH PLANS, INC. H2997 - ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC. H3342 - EMPIRE HEALTHCHOICE ASSURANCE, INC. H3370 - EMPIRE HEALTHCHOICE HMO, INC. H3655 - COMMUNITY INSURANCE COMPANY H4036 - ANTHEM INSURANCE COMPANIES, INC. H4909 - ANTHEM INSURANCE COMPANIES, INC. H5422 - BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA H5529 - COMMUNITY INSURANCE COMPANY H5530 - ANTHEM HEALTH PLANS OF KENTUCKY, INC. H5679 - HMO COLORADO, INC. H5854 - ANTHEM HEALTH PLANS, INC. H8552 - ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY H9947 - BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. R5941 - ANTHEM INSURANCE COMPANIES, INC. | Elevance Health, Inc. | Customer Service | 8882307338 | 21826 | 28-FEB-2012 | Health and Drug Benefit | Bid Submission | Actuarial deficiencies regarding bids submission. | n2wm_02292012170344352.OACT 2012 - Wellpoint Final Email Ready.pdf
H4155 - PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY | Public Health Trust of Miami-Dade County |  |  | 21824 * | 28-FEB-2012 | Health and Drug Benefit | Bid Submission | Actuarial issues regarding bids. | n2wm_02292012165555843.OACT 2012 - Public Health Trust of Miami-Dade County Final Email Ready.pdf
H5590 - Bridgeway Health Solutions of Arizona, Inc. | Centene Corporation | Provider Services | 8773915921 | 20980 | 06-JAN-2012 | Drug Benefit | 4Rx Submission and Accuracy Problems | Failure to submit 4Rx data in a timely manner for the 2012 plan year. | m5nx_01122012094621597.FinalCAP 4Rx letter 162012 H5590.pdf
Report Created: 10/1/2023 | 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