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Health and Medicine


SummaCare ordered to suspend Medicare enrollment
U.S. Department of Health and Human Services cites 38 violations tied to delayed or denied coverage
by WKSU's KABIR BHATIA


Reporter
Kabir Bhatia
 
In The Region:
Akron-based SummaCare is under fire from the U.S. Department of Health and Human Services for allegedly mishandling supplemental coverage for Medicare recipients. WKSU’s Kabir Bhatia reports.
SummaCare ordered to suspend Medicare enrollment

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The Centers for Medicare and Medicaid Services has ordered the insurance company to stop marketing efforts to enroll Medicare patients. The move follows an 11-day audit in June that found 38 instances of SummaCare failing to comply with the requirements for drug and supplemental Medicare coverage.

In a letter to the insurer this week, the federal agency said the violations stem from a lack of internal controls.

Elizabeth Schinderle says the suspension is in place until SummaCare has corrected the issues.

“CMS is taking action against an insurance company that delayed or denied beneficiaries’ access to prescription drugs and Medicare covered services and inappropriately charged additional costs for Medicare covered services and prescription drugs.”

Patients currently enrolled in SummaCare should not be affected, but anyone having difficulty getting benefits should call 1-800-MEDICARE. 

SummaCare has until Monday to submit a Corrective Action Plan, and until Wednesday, August 27 to request a hearing. Calls to Summa were not returned.
Listener Comments:

Summa is filled with corruption at multiple levels


Posted by: conan (arkon) on August 17, 2014 3:08AM
I'm not surprised at all.


Posted by: Anthony (Akron) on August 15, 2014 6:08AM
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