SunCoast Physicians Health Plan, a small Medicare Advantage HMO in Weston, Fla., has lost its contract with the CMS after being placed in receivership by a Florida judge because of financial distress and alleged fraud.
The plan will be liquidated and the state will investigate the true state of SunCoasts financial affairs, according to an order by a Second Circuit Court judge in Tallahassee, Fla.
The state asked that SunCoast be dissolved because it was $813,000 in the red, had misrepresented a $1.4 million loan as assets, and was sold to new shareholders in 2006 without state knowledge or approval. In addition, nearly all the plans officers and directors have resigned, according to court documents.
SunCoast was in such a disastrous financial condition that allowing it to continue would be hazardous to its policyholders, creditors, stockholders or the public, wrote Yamile Benitez-Torviso, attorney for the Florida Department of Financial Services in the petition for receivership.
SunCoast's 600 members will be enrolled in a Humana Medicare plan with similar benefits. The CMS chose Humana because of its large presence in South Florida, a spokesman for Humana said.
SunCoast officials could not be reached for comment. Its Web site points visitors to information about the receivership, and describes SunCoast as built on traditional medical values, when medicine was about caring for patients not managing them.
Last month, the CMS terminated its Medicare Advantage contract with another Florida plan, Americas Health Choice, Vero Beach, citing quality-of-care issues. -- by Rebecca Vesely
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