CMS Lifts Aetna Restrictions on Medicare Part D Enrollment As of July 1, 2011

Part D folks will once again be able to enroll with Aetna after a year of punishment from CMS for not properly handling drug benefits and patients had problems with access to Part D drugs. So once again you will see Aetna marketing Medicare Advantage and Prescription Drug Plans.

This could be beneficial in area to where selection of insurers is limited to have one more choice. 6 of one and half a dozen of another. Earlier this year Aetna pulled out of Colorado for Individual Health Insurance Plans but Part D could be available there, check out Medicare.Gov and see what they have listed.

^{Aetna pulls Out of Individual Health Insurance Policies in Colorado as of August of 2012-Risk and Profit Algorithms At Work}

Algorithmic business models can sometimes be very confusing as the math determines areas of profitability and some offerings are here today but gone in a few months at times. BD

Aetna plans to enroll new Medicare beneficiaries by July 1 in response to the lifting of year-old federal sanctions.

The Centers for Medicare & Medicaid Services removed marketing and enrollment restrictions established last April. Aetna has since corrected its deficiencies, the CMS determined after a review of documentation and the conducting of validation exercises, according to a letter sent to Aetna President and Chief Executive Officer Mark T. Bertolini. Small issues remain, but none which should have prevented the reprieve, wrote Brenda J. Tranchida, director of CMS' program compliance and oversight group.

"We have worked very hard to implement improvements to a number of areas that will further support beneficiary access to care, patient safety and compliance with CMS guidelines," Bertolini said in a statement. "Most important, our actions will enhance our ability to support the nearly 1 million Medicare beneficiaries we are privileged to serve today."

Aetna recently announced an agreement to acquire the Medicare supplement and related blocks of in-force business of Genworth Financial Inc. for about $290 million in a deal to expand its presence in the health insurance market for seniors (BestWire, June 13, 2011). The transaction includes the sale of Continental Life Insurance Co. of Brentwood, Tenn., and its American Continental Insurance Co. subsidiary, with Aetna acquiring 100% of Continental Life's stock. It also includes reinsurance agreements to transfer to Aetna the Medicare supplement in-force business sold by certain Genworth life insurance subsidiaries.

Insurance News - CMS Lifts Aetna Sanctions on Medicare Enrollment