Did the Aetna/Coventry Merger Get them in Trouble with CMS?

[txagent41]

Back in September, whenever I finished my recontracting and recertification, I called Coventry and they told me I was good to go, and I should receive my "Ready to sell" notification email within a week.

3 months later, I've still yet to receive that notice.

I was running a Part D today, and was scrolling all the plans, and when I got to the bottom, I noticed that you can no longer view their 4 plans.

 

[fleur]

Temporary issue is affecting pharmacy network information for Aetna and Coventry Medicare plans. A fix is in progress.

We recently discovered that network status for a limited number of pharmacies for Aetna and Coventry Medicare plans (MAPD, PDP) is displaying inaccurately in online tools such as the Medicare.gov Plan Finder site, AetnaMedicare.com and Coventry-Medicare.com. This is due to a coding issue on the pharmacy network file we submitted to CMS.







The issue has caused certain pharmacies to appear as being in-network when in fact they are not. We are working closely with CMS to fix this as quickly as possible.

 

[G.Gordon]

I'm thinking that pharmacy network issue might be a big problem for some markets. Say you run a plan review, drugs look fine at that pharmacy. The truth is that the pharmacy selection is not in network. I'm wondering if this can be used as a hardship SEP. Of course using such SEP would require changing plans via 800Medicare and losing out on Commissions for the year on that client.

 

[Chazm]

Back in September, whenever I finished my recontracting and recertification, I called Coventry and they told me I was good to go, and I should receive my "Ready to sell" notification email within a week. 3 months later, I've still yet to receive that notice. I was running a Part D today, and was scrolling all the plans, and when I got to the bottom, I noticed that you can no longer view their 4 plans.

They had some issues with contracting since the merge. I had to call to get it squared away.
With me, they neglected to tell me I had an error on the contracting page with one spot having my name misspelled.
They let me do all the training and even the face to face before I had to find out on my own what the issue was.