Many people have received letters of ‘non-compliance’ from Care Management Solutions. It is important to note that the list of ‘non-compliant’ HEP members is not up-to-date and CMS is working to update the high volume of notifications of compliance.
However, no matter what a letter from CMS might say, no HEP member can be removed before all the claims are in and reviewed, and removal can only happen by an affirmative vote of the HCCC [Healthcare Cost Containment Committee] or by a ruling from an arbitrator. This process is only briefly mentioned at the end of the ‘non-compliance’ letter and reads: “…your situation will be presented to the HCCC for possible removal from the financial advantages of HEP”.
Even if a letter of ‘non-compliance’ has been received, health insurance premiums will NOT increase in March; there will be further updates of compliance and a determination of ‘non-compliance’ requires a review process that precedes any removal from HEP.
If all of the necessary requirements for compliance have been met and any required notifications of compliance have been submitted, then removal from HEP will not occur and please continue to follow the requirements for the current year.
If you have not completed all HEP requirements and wish to remain on HEP, then absolutely continue to meet all 2013 requirements as soon as possible despite the deadline date of February 28th; completion of HEP requirements will ensure qualification for continued HEP enrollment and/or re-enrollment into HEP.