30,000 In Health Plan Taken Out, Out, Out

By CAROL GENTRY The Tampa Tribune

Published: Jun 30, 2007

TAMPA - Federal officials quietly canceled enrollments of about 30,000 Medicare beneficiaries from the troubled Any, Any, Any health insurance plan soon after its launch Jan. 1 and are withholding money from the company's payments as reimbursement for premiums covering months they were enrolled, government and company officials confirmed this week.

The massive "retroactive disenrollment" is the first permitted by the Centers for Medicare and Medicaid Services. In the past, retrospective cancellation had been done only one beneficiary at a time and was rare, they said.

"There's nothing even close" to the number of reversed enrollments that occurred with Any, Any, Any, CMS spokesman Steve Hahn said Friday.

Most of the disenrollments occurred within the first three months of this year, but it's unclear how many are now in traditional Medicare or with other insurance plans.

The number of reversed memberships was confirmed Thursday via e-mail by Akshay Desai, president and CEO of Universal Health Care Group of St. Petersburg. Any, Any, Any, a private fee-for-service plan, is sponsored by the company's largest subsidiary, Universal Health Care Insurance Co. of St. Petersburg.

Desai, responding to e-mailed questions from The Tampa Tribune, said by e-mail there are still 70,000 members in the Any, Any, Any plan.

He gave it that name, Desai has said in past interviews, because the plan would pay for treatment by "any doctor, anywhere, anytime." As it turned out, many beneficiaries had trouble finding a doctor who would accept the coverage.

In mid-February, the company stopped sales of the plan, under state and federal pressure. A week later, state insurance officials placed the subsidiary under state supervision, saying it had insufficient financial reserves.

The company was able to fend off a state takeover, however, by filing for protection from the courts. That action is pending. Meanwhile, on Thursday the company announced that as of May it had $27.6 million in surplus - well short of the $100 million-plus the state called for, but well north of insolvency.

Universal's Medicare managed-care plans, which have doctor networks, were never affected by the troubles with Any, Any, Any.

The revelation that CMS permitted about 30,000 retroactive disenrollments may explain why former sales agents complain that they never received commissions for some of their enrollees. If the cancellation were retroactive to Jan. 1, it would be erased from the books.

The subject of retroactive disenrollments came up this week at a House investigations subcommittee hearing on "predatory sales practices" by agents for Medicare Advantage plans. Universal was not mentioned by name, but Abby L. Block, director of CMS' Center for Beneficiary Services, alluded to it in announcing new guidelines to implement disenrollment - going forward or retroactive - for "any beneficiary who believes he or she was enrolled in a plan without consent or through misinformation."

Beneficiaries can initiate the action through the toll-free line 1-800-MEDICARE.

The Any, Any, Any plan was sold in eight states. Of the current members, 38 percent are in Florida, said Universal spokesman Bob O'Malley. He said he did not know how many of those disenrolled were Floridians.

Reporter Carol Gentry can be reached at cgentry@tampatrib.com or (813) 259-7624.