Important Notice on MAPD HMO Plan Termination Effective March 1, 2020
Effective February 29, 2020, Quality Health Plans of New York (QHPNY) will terminate its contract with the Centers for Medicare and Medicaid Services (CMS).
Quality Health Plans of New York won’t offer Medicare plans after February 29, 2020. This means coverage through Quality Health Plans of New York will end February 29, 2020.
It has been our honor to serve you. Quality of Health Plans of New York would like to thank you for the opportunity and sincerely apologizes for any inconvenience this may cause.
For more information members should refer to the notices recently mailed or call Customer Service at 1 (877) 233-7058 (TTY/TDD: 711). Until March 31st, you can call us 7 days a week from 8:00 a.m. to 8:00 p.m. and from April 1 to April 30th, you can call us Monday through Friday from 8:00 a.m. to 8:00 p.m.
You may also call 1-800-MEDICARE (1-800-633-4227). Tell them your plan isn’t going to be offered after February 2020 and you want help choosing a new plan. This toll-free help line is available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
Effective November 19, 2018, the Centers for Medicare and Medicaid Services (CMS) imposed intermediate sanctions on Quality Health Plans of New York (QHPNY). This means that QHPNY can not accept new enrollments into our plan and/or market to enrollees, at this time.
There were four reasons QHPNY was sanctioned:
- Failing to meet CMS financial requirements.
- Failing to file these financial statements timely.
- Failing to pay 95% of out-of-network providers within 60 days.
- Failing to notify out-of-network providers of claim denial decisions within 60 days after receipt of service requests.
If you are a current QHPNY member, the benefits you have as a member of your current plan will not be affected in any way and will continue while QHPNY is sanctioned. You still have access to our providers and pharmacy network and coverage for medical services and drugs on our formulary.
QHPNY is working diligently to resolve these issues as quickly as possible and we apologize for the inconvenience.