For Immediate Release: March 10, 2010

Contacts: Kristin Milam 919-824-0024

Fox Insurance's Medicare Part D Plan Contract Terminated by Medicare

North Carolina's 24,000 Fox enrollees should call SHIIP for help

RALEIGH -- Insurance Commissioner Wayne Goodwin today announced that the Department's SHIIP program is available to help some 24,000 N.C. Medicare recipients who are affected by Medicare's immediate termination of Fox Insurance Company of New York's Part D prescription drug plan contract.

"The news that Medicare has terminated Fox's contract comes just after we learned that Fox was delaying prescriptions to its new enrollees," said Commissioner Goodwin. "Just like then, I want North Carolina's Medicare recipients enrolled in a Fox Insurance Company Part D plan, to know that the Department's SHIIP program can help. I also want to assure folks that they are not losing their Medicare prescription drug coverage and they will still be able to get their medicine. " Goodwin added that SHIIP counselors are standing by in the SHIIP call center in Raleigh to answer questions. Call 1-800-443-9354.

Effective immediately, Medicare recipients currently enrolled in Fox will receive their prescriptions from LI-NET, a program run by Medicare and administered by Humana. Fox members will be able to choose a new Medicare prescription drug plan through April 30, 2010. Current members who do not choose a plan will be automatically enrolled into a new plan by Medicare to be effective May 1, 2010. SHIIP can help Fox members switch to a new Medicare prescription drug plan.

Last week, Medicare suspended Fox's enrollment for their Part D plan because it identified that the company had not been able to meet the needs of its new members by failing to provide timely access to prescription drugs covered under the Part D plan. The company was requiring prior authorization and step therapy when filling prescriptions - requirements not approved by CMS (Centers for Medicare and Medicaid Services) - as well as not meeting the necessary appeals deadlines and requirements for transitioning new enrollees to the covered drugs.

According to CMS, an onsite audit of the plan and its services determined that the plan had significant deficiencies that jeopardized the health and safety of Fox members. CMS found that Fox committed a series of violations, including improperly denying its members coverage of critical HIV, cancer, and seizure medications.

Medicare recipients with questions about Fox Part D plans or any Medicare-related issue should contact SHIIP (Seniors' Health Insurance Information Program) at 1-800-443-9354.

SHIIP is a division of the North Carolina Department of Insurance that offers free, unbiased information about Medicare, Medicare prescription drug coverage, Medicare Advantage, long-term care insurance and other health insurance information. SHIIP's trained volunteers provide one-on-one counseling in all 100 counties. More information is available at www.ncshiip.com.

  • Number of members affected per North Carolina Counties
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