June 19, 2014

PUP Member Claims to be Paid Under Medicare FFS Retroactive to June 1-

On June 19, the Florida Department of Financial Services issued to providers the following notice (insert attachment) regarding its receivership of Physicians United Plan (PUP).

As a result of the impending liquidation of PUP and termination of its contract with Centers for Medicare and Medicaid Services (CMS), CMS has retroactively enrolled all PUP members into the Original Medicare Fee For Service and a Prescription Drug Plan effective June 1, 2014.

 

  • Providers who have delivered services to members on or after June 1, 2014, should submit claims under Medicare Fee for Service.
  • Providers should hold these claims until June 23, 2014 (it will take until the 23rd to process the enrollments in the Medicare systems) and then submit them for payment.
  • Providers who were reluctant to provide health services to PUP members should see these individuals and submit the claims to Original Medicare for prompt payment after June 23, 2014.
  • All beneficiaries enrolled in PUP have a prospective Special Election Period (SEP) until Aug. 31, 2014, to enroll in a health plan of their choosing. PUP members who are dual eligible or receive low
  • income subsidies have an unlimited right to join another plan.
  • Providers or beneficiaries with any questions regarding this retroactive enrollment for billing should contact Medicare directly at 1-800-MEDICARE (1-800-633-4227).

 

Questions? Contact Kim Streit, vice president of healthcare research and information, at (407) 841-6230.