The Centers for Medicare & Medicaid Services says a large health insurer will have to sit on the Medicare drug plan market sidelines until it resolves CMS compliance concerns.
CMS intends to make Aetna Inc., Hartford (NYSE:AET), suspend new sales of Medicare Advantage plans with drug coverage and stand-alone Medicare Part D prescription drug plan coverage starting April 21, officials say.
Aetna has about 400,000 enrollees in Medicare Advantage plans with prescription benefits and 600,000 in prescription drug plans.
The marketing suspension will not affect current plan members, officials say.
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The suspension also will not have much immediate effect on marketing efforts, because the next open enrollment will not start until October.
CMS has accused Aetna of changing its Medicare plan drug formulary, or approved drug list, to a closed list, from an open list, and then failing to provide the required level of continued access to the drugs taken off the formulary.