In addition to the termination of the contract, the agency is imposing “intermediate sanctions” to suspend all enrollment and marketing activities for the plans, effective Jan. 12.
“The intermediate sanctions will remain in effect until CMS is satisfied that the deficiencies that are the basis for the sanction determination have been corrected and are not likely to recur,” CMS wrote Dec. 27.
WellCare does have the opportunity to appeal. Centene has been working to improve its Medicare Advantage star ratings. The percentage of Centene members with four-star or higher plans dropped from 48 percent to 3 percent in 2022.
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