HNF Stories
6:10 pm
Fri June 13, 2014

Don't Abandon PUP Patients: State

Health care providers under contract with the beleaguered Physicians United Plan are being warned to continue treating patients, as they undergo a special enrollment period to join more financially stable plans .

The Department of Financial Services on Friday said it sent a letter to providers after hearing reports of patients being denied coverage after the Medicare Advantage plan was placed under state control earlier this week. 

Refusing to care for seniors enrolled in the plan known as PUP violates terms of the receivership and liquidation scheduled to start July 1, the state said in a fax blasted to providers on Friday.

“Refusal of care, cancelation of appointments and any similar activities impacting member care form the basis for nonpayment of services and other state action,” the letter said.

Credit Physicians United Plan logo

Since 2005, Physicians United Plan Inc. has offered four different Medicare Advantage plans to 39,000 seniors in 17 Florida counties. Most are in Central Florida and the Tampa Bay area.

All of them will be allowed to apply for new plans under a special enrollment period announced Friday by the Centers for Medicaid and Medicare Services. They have until August 31 to make a selection.

The agency said beneficiaries must notify CMS that they want to choose a new plan by June 30 if they want coverage starting July 1.  Physicians United policy holders must call 1-800-MEDICARE to make the special enrollment request. They can then apply directly to other Medicare Advantage plans approved in the region. Members wanting help picking a new plan can get help from volunteer counselors in Florida's Serving Health Insurance Needs of Elders (SHINE) program. That phone number is 1-800-963-5337 or visit online at www.FloridaShine.org.

In regards to the financial liquidation, a Leon County circuit judge last week approved the DFS takeover request to liquidate Physicians United. The state immediately took control of the Orlando company’s property and assets.

Court records show that Physicians United was nearly $13 million in debt and couldn’t pay many of the health care providers with whom they had contracts. The company has been in financial trouble since 2007, reports show, and most recently was unable to raise enough capital to stay afloat.

The DFS said policy holders seen between now and June 30 – the day before the liquidation takes place – will be treated as a “high-priority” administrative expense.

“Please continue to see members,” the letter said. “Please do not refuse service to members.”

Patients who depend on prescription refills, including diabetics, say they are having trouble getting their medications, WFTV reports.  And the Orlando Business Journal wonders what is going to happen to the plan's fleet of  PUP-mobiles.

Policy holders will have the opportunity to sign up for new Medicare Advantage plans or enroll in traditional Medicare. The federal Centers for Medicare and Medicaid Services will handle that transition and will contact policy holders by mail. Also, policy holders can call 1 800 MEDICARE.