CMS Fines Regence $100,000 for Medicare Violation
November 30, 2011 – The Centers for Medicare and Medicaid Services has imposed a $100,000 civil penalty against The Regence Group for failing to provide accurate information to its Medicare Advantage members. The Regence Group is the holding company for the company’s insurance products in Oregon, Washington, Idaho and Utah.
During 2011, Regence failed to send accurate information about the cost-sharing changes for durable medical equipment and related supplies, including prosthetic devices, to its 88,667 Medicare Advantage members, according to Gerard J. Mulcahy, acting director of the Program Compliance and Oversight Group for CMS.
That failure “directly adversely affected or had the substantial likelihood of adversely affecting those enrollees,” he told Mark Ganz, CEO of The Regence Group.
“Regence failed to provide Medicare enrollees with vital information about changes to benefits and cost-sharing,” according to that letter.
Because of that failure, Medicare members “did not have ample opportunity to consider plan changes in order to make an informed healthcare choice during the 2011 Medicare Annual Election Period.”
Instead of paying the fine, Regence had the opportunity to request a hearing to appeal the determination by CMS, but chose not do so, according to Georganne Benjamin, assistant director of strategic communications for The Regence Group.
“Regence inadvertently omitted information regarding a change in the cost sharing specific to durable medical equipment and related supplies when we provided benefit plan change information to our Medicare Advantage members for the 2011 contract year,” she told The Lund Report..
“This was a one-time benefit information error and correct information was subsequently provided to all affected members,” she added. “Regence acknowledged its error and did not request a hearing. Since five separate Regence affiliate companies serve Medicare beneficiaries in five separate markets, we paid a total fine of $100,000 - $20,000 for each affiliate which is the same amount as other local and national carriers who made similar errors.”
The Regence Group Board of Directors in 2010
Many of the readers of The Lund Report have asked us to publish the list of board members of The Regence Group. We obtained that list from the 2010 filing by The Regence Group to the Washington Insurance Commissioner’s Office as required by law.
Mark C. Adams, 505 Broadway, Unit 505 Tacoma, WA [email protected]
S. Fred Beck, CFO, ICON Health & Fitness,1500 South 1000 West, Logan, UT [email protected]
Cynthia A. Bioteau, PhD, President and CEO,Salt Lake Community College, 4600 South Redwood Road,Salt Lake City, UT [email protected]
Gregory L. Charlton, Senior Vice President, Idaho Independent Bank, 401 W. Front St., Ste 1000, Boise, ID, [email protected]
William L. Chenevich, Vice Chairman, U.S. Bank,17650 NE Sandy Blvd., Portland, OR, [email protected]
Peggy Y. Fowler, Retired President/ CEO, Portland General Electric
Mark B. Ganz, President & CEO, The Regence Group, PO Box 1071, MS:E15A, Portland, OR [email protected]
Mark L. Hogans, CEO, M. L. Hogans, LLC Consulting, Services and Executive Director, Puget Sound BOLD Initiative
9908 SE 5th Place, Bellevue, WA [email protected]
Paula A, Jones, President and CEO, P.A. Banks Enterprises, Inc., 1821 South Prairie, Chicago, IL [email protected]
Michael G. Koppel, VP and CEO, Nordstrom, Inc., 1617 6th Ave., 6th Floor, Seattle, WA 98101, [email protected]
Katharine G. Lindemann, SVP, Savers, Inc., 11400 SE 6th St., Ste 220, Bellevue, WA [email protected]
Luis Machuca, CEO, Kryptiq Corporation, 3600 NW John Olsen Place, Hillsboro, OR [email protected]
Dr. D. Kurt Seppi, St. Luke’s Magic Valley Medical Center, 650 Addison Avenue West, Twin Falls, ID [email protected]
Jack G. Strother, Attorney, Graham and Dunn, Pier 70, 2801 Alaskan Way, Ste 300,Seattle, WA [email protected]
FOR MORE INFORMATION
To read about how regulators didn’t question the $56.5 million payout by Regence BlueCross BlueShield, click here.
To read about the leadership shake-up at Regence click here.
To read about the investigation of Regence by Washington’s insurance commissioner, click here.
To read about Regence BlueCross BlueShield’s losing its status as the leading insurer in Oregon, click here.