The Centers for Medicare and Medicaid Services has sanctioned the CVS SilverScript Medicare Part D prescription drug plan because of claims processing issues. As a result, CVS has suspended enrollment and stopped all marketing activities while it works to resolve service issues. CVS says that an enrollment system conversion caused problems with enrollment processing. In some instances, consumers were not able to have claims adjudicated at the pharmacy. As a consequence, the Centers for Medicare and Medicaid Services (CMS) has placed SilverScript on intermediate sanctions, effective as of 11:59PM EST January 15, 2013.
The CMS action does not affect SilverScript members; they will continue to have access to covered services. The action does not affect existing employer group health plans or CVS Caremark health plan clients. The company estimates that the sanctions should not have a material affect on its 2013 earnings. “We take these issues very seriously and are committed to working swiftly with CMS officials to address their areas of concern. We also want to commit to members who experienced enrollment issues that we will resolve these expeditiously,” said Jon Roberts, president of the pharmacy benefit management business of CVS Caremark.
