News Briefs

✦ CMS’s 2019 Medicare Parts C and D program audits resulted in civil monetary penalties amounting to nearly $1.2 million imposed on six organizations, according to CMP notices posted at www.cms.gov. The agency in a memo dated Feb. 28 released the audit scores of the 13 organizations that underwent 2019 program audits, with scores ranging from 0 to 1.74 (the lower the score, the better the performance). Outside of the program audit process, CMS barred Medicare Advantage and Prescription Drug Plan operator Delaware Life Insurance Co. from marketing and enrollment activities and imposed a CMP on Miami-based Solis Health Plans, Inc. for failing to ensure that its agents and brokers followed Medicare marketing rules during the 2019 Annual Election Period. View all the notices at https://go.cms.gov/2x1Q7vP.

✦ After two cycles of marketing Medicare Advantage plans during the Annual Election Period, Mutual of Omaha has decided to sell its MA businesses to Essence Healthcare, sister company of Lumeris. According to a Feb. 24 press release from Essence and Lumeris, Essence will acquire the two Mutual of Omaha subsidiaries that offer MA plans in the Cincinnati, Dallas, Denver, El Paso and San Antonio markets. Lumeris has served as an operating partner to Mutual of Omaha since 2018 and operates MA plans under the Essence Healthcare brand (RMA 4/5/18, p. 1). The companies did not disclose financial terms of the deal, which is expected to close by mid-2020, and declined to provide additional details when queried by AIS Health. According to AIS’s Directory of Health Plans, Mutual of Omaha had 2,416 total enrollees in MA plans in Colorado, Kentucky, Ohio and Texas as of February, compared with 920 members this time last year, when it served just the Cincinnati and San Antonio markets. Contact Lumeris spokesperson Marcus Gordon at mgordon@lumeris.com.

© 2021 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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