Medicare Plan to Be Shut Down

From Health News Florida by Vincent Kuntz

Quality Health Plans, a Medicare HMO with 10,000 Florida members, has been ordered into liquidation after failing to come up with the cash reserves the state says were needed. Its members will be moved to another — still unnamed — plan by Dec. 1.

Circuit Judge Terry P. Lewis signed the order (view HERE), which turned over control of the company’s assets to the Division of Financial Services, after an hour-long hearing Wednesday in Tallahassee.

The Tampa-based plan, which operates in 32 Florida counties and four in New York, had been warned it had to come up with cash at a hearing last month.

But it didn’t. At Wednesday’s hearing, DFS Deputy Chief Attorney Robert V. Elias said, “What we have is a company that is deeply insolvent.”

It wasn’t clear this morning which company will be taking in the members of QHP. In the 2008 liquidation of another Tampa plan, MD Medicare Choice, the 16,000 members were moved to Humana. They were allowed to remain there, move to another plan or return to traditional Medicare.

In the QHP case, DFS originally acted in August after state insurance officials determined the company didn’t have sufficient cash reserves as required by law. The company had sought $35 million from an equity investor, with a deadline of Tuesday, but wasn’t able to get it.

An Oct. 17 court document says the state sought receivership of the company solely based on QHP’s finances, with no findings of fraud or misconduct. But QHP was suspended in May 2010 from the federal Medicare program and fined nearly $600,000 following a rash of enrollee complaints about billing glitches, improper denials and delays of medication, and failure to provide an adequate appeals and grievance process.

QHP also offers Medicare Advantage coverage in four counties in New York, according to the company’s website (qualityhealthplans.com). The company is run by president Haider A. Khan, M.D.; his son Nazeer H. Khan, M.D., who is CEO; and daughter Sabiha H. Khan, the COO.

Health News Florida called QHP seeking comment Wednesday, but was unable to reach anyone who could speak on behalf of the company.

QHP members’ health care coverage continues uninterrupted, according to DFS’ Division of Rehabilitation and Liquidation. Its website offers answers to questions.

DFS officials encouraged enrollees to read carefully any letters they receive from QHP or the Centers for Medicare and Medicaid Services, a federal agency that administers Medicare premiums and contracts.

Members’ claims should be covered as usual. Anyone who runs into trouble can call DFS at (800) 882-3054, the agency’s website says.

Health-care providers cannot seek payment from members for debts that QHP owes, state officials say.


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