Claude Vincenti, president of SummaCare says they took the federal action very seriously.
ClaudeCUT: We're a community based organization, so when something like this happens it's, um, you know we want to rectify it as soon as possible because we want to continue being a valuable part of the community.
The Centers for Medicare and Medicaid said in 10-page sanction letter last year that enrollees experienced inappropriate denials or delays for medications and medical services. They also had inappropriate out-of-pocket costs for services and medications that were supposed to be covered.
SummaCare was allowed to keep current enrollees but banned from marketing for OR enrolling new members. It's enrollment dropped from 33,000 in 2014 to a current 28,000.