CMS has reported an issue in the MARx system involving incorrect Medicare Part A and/or Part B entitlement data, resulting in some Medicare Advantage (MA) and Prescription Drug Plan (PDP) members being disenrolled. We have been notified that some carrier partners, including HealthSpring, have been affected.
HealthSpring and other carrier partners are required to follow CMS disenrollment rules when CMS systems indicate a loss of entitlement, even if the issue originates from a CMS data error.
If a beneficiary believes they were disenrolled incorrectly, agents should direct them to contact HealthSpring directly first, followed by the Social Security Administration, as needed to resolve entitlement records.
Please watch for any communication from HealthSpring and other carrier partners related to this issue, including guidance on how they are directing agents to support affected clients during this time.
Should you have any questions, please reach out to a Fidelis Team Member. We are here to support you!
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