SHIBA News Flash -- Feb. 14, 2020

SHIBA News Flash
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CMS announces sanctions against Clear Spring plans

On Jan. 31, 2020, the Centers for Medicare & Medicaid Services (CMS) imposed sanctions against plans owned by Delaware Life Insurance Company. In Washington state, this includes two Part D plans: Clear Spring Health Premier Rx and Clear Spring Health Value Rx.

The sanctions are for the plans’ failure to:

  • Timely and accurately process beneficiary enrollment requests.
  • Provide beneficiaries prompt notice of acceptance or denial of enrollment requests.
  • Provide proof of coverage and other required plan materials prior to the enrollment effective date.
  • Ensure Part D benefits are administered to its enrollees at the point-of-service.
  • Provide information on a timely basis to current and prospective enrollees when enrollees contact the customer service call center.

The plans must stop enrolling new members and cannot market their products until approved by CMS. There's no stipulation to change current plan members to other plans. We recommend that anyone experiencing difficulty with their Clear Springs Part D plans contact SHIBA at 1-800-562-6900 or Medicare at 1-800-633-4227 for assistance. 

Beware of potential census scams

April 1, 2020, is Census Day - the start of the U.S. Census. With it comes potential scams. Please remind clients to keep their personal health and Medicare information safe. 

Census takers might ask them about things like their home life or relatives, but they will never ask them for their:

  • Social Security Number
  • Medicare number
  • Health insurance information

If someone asks them for their Medicare number or they suspect Medicare fraud, report it to Medicare at 1-800-633-4227. TTY users can call 1-877-486-2048.

For more information about the Census, go to 2020census.gov or call 1-809-923-8282. TTY users can call 1-800-877-8339.