Feds Lift WellPoint's Medicare Advantage, Part D Suspension

A CMS review of the insurer in January found "widespread and continued failures by WellPoint to properly administer their contracts in accordance with CMS requirements." CMS had identified WellPoint's noncompliance in several areas, including: enrollments and disenrollments; benefits administration—including determining premiums, and co-pays; grievances and appeals; marketing; claims processing; coordination of benefits; billing; and meeting call center and customer service requirements.

Indianapolis-based WellPoint is the nation's largest health benefits company, with more than 34 million members in its affiliated health plans. It owns Blue Cross and Blue Shield plans in 14 states. WellPoint has 1.2 million beneficiaries in its Part D plans, 462,000 in its Medicare plans, and 802,000 in Medicare Supplement plans for a total of about 2.5 million Medicare members.