Wellcare Health Plan : WellCare Joins Industry in Compliance Pledge to Protect Medicare Beneficiaries
06/15/2007| 05:10pm US/Eastern
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WellCare Health Plans, Inc. (NYSE:WCG) today announced that it has
joined six other leading Medicare Advantage health plans in pledging to
strengthen consumer protections for Medicare beneficiaries. This pledge
includes the accelerated implementation of the recently-released 2008
CMS marketing guidance, as well as the development of best practices for
compliance oversight of independent sales agents. To allow time for
these activities, the pledge includes a temporary suspension of
marketing of WellCare's private
fee-for-service (PFFS) plans.
?We are committed to delivering high-quality
products and services to our Medicare beneficiaries,?
said Todd S. Farha, chairman and chief executive officer. ?We
are accelerating our compliance with the 2008 CMS marketing guidance
ahead of schedule. This action demonstrates our commitment to
best-in-class compliance practices to protect seniors.?
WellCare is working with the Centers for Medicare & Medicaid Services
(CMS), America's Health Insurance Plans
(AHIP), the National Association of Insurance Commissioners (NAIC) and
other leading Medicare Advantage health plans to develop consistent
compliance and oversight standards for independent sales agents.
WellCare has previously announced enhancements to its compliance program
for its PFFS products, including an inbound telephone enrollment and
verification process and a ?secret shopper?
program using an independent organization to anonymously monitor field
marketing activity. These enhancements are in addition to extensive
compliance efforts already in place for independent sales agents,
including:
-
Confirmation of agents' state licensure
-
Extensive criminal background screening
-
Mandatory training and testing on product benefits and marketing
guidelines
-
Mandatory contract terms, incorporating a sales agent code of conduct
-
On-site monitoring of agents by field sales management
-
Post-enrollment outreach calls to 100% of new members
-
Mandatory re-training and re-testing to refresh knowledge of plan
terms and marketing guidelines
-
Rapid resolution of any identified compliance issues
-
Zero tolerance for verified infractions
?We have zero tolerance for deviations from
CMS standards or WellCare's code of conduct,?
said Thaddeus Bereday, WellCare's chief
compliance officer. ?We welcome the
opportunity to enhance our existing compliance procedures by
implementing the 2008 CMS marketing guidance.?
The temporary suspension of new PFFS sales activity will have no effect
on existing members in WellCare's Medicare
Advantage plans. In addition, the temporary suspension of marketing does
not affect WellCare networked Medicare Advantage plans. Members can
continue to access providers and benefits as outlined in their plans.
Providers and members can call WellCare's
toll-free customer service phone number (1-866-238-9898; TTD/TTY
1-866-239-6265) to have their questions answered.
The Company's voluntary suspension of
marketing of its PFFS products will not affect its previously issued
second quarter or full-year 2007 revenues or earnings per share
guidance. As of March 31, 2007, WellCare reported over 32,000 members in
its PFFS plans.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services exclusively
for government-sponsored healthcare programs, focusing on Medicaid and
Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of
Medicaid and Medicare plans, including health plans for families,
children, the aged, blind and disabled and prescription drug plans,
currently serving more than 2.27 million members nationwide. For more
information about WellCare, please visit the Company's website at www.wellcare.com.
Cautionary Statement Regarding Forward-Looking Statements
This release contains ?forward-looking?
statements that are made pursuant to the Safe Harbor provisions of the
Private Securities Litigation Reform Act of 1995. Statements that
are predictive in nature, that depend upon or refer to future events or
conditions, or that include words such as ?expects,?
?anticipates,? ?intends,?
?plans,? ?believes,?
?estimates,? and
similar expressions, including, but not limited to, statements related
to WellCare's expected 2007 financial
results, are forward-looking statements. Forward-looking
statements involve known and unknown risks and uncertainties that may
cause WellCare's actual future results to
differ materially from those projected or contemplated in the
forward-looking statements. Additional information concerning
these and other important risks and uncertainties can be found under the
captions ?Cautionary Statement Regarding
Forward-Looking Statements? and ?Risk
Factors? in the Company's
Annual Report on Form 10-K filed with the Securities and Exchange
Commission on February 16, 2007 which contains discussions of the Company's
business and the various factors that may affect it.
WellCare Health Plans, Inc.
Media Contact: John
Aberg, 813-865-5045
john.aberg@wellcare.com
or
Investor
Contact: Gregg Haddad, 813-865-1284
gregg.haddad@wellcare.com
© Business Wire 2007
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