Federal raid threatens supplemental insurance for thousands - DC News FOX 5 DC WTTG

Federal raid threatens supplemental insurance for thousands

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ATLANTA -

Federal agents raided the Florida headquarters of Universal Health Care, shutting down the offices and leaving hundreds of employees out of work.  The move means 7,500 Georgians could potentially be without supplemental health insurance.

This is a government-approved Medicare insurance company.  If you are signed up for their supplemental health plan, this might be the first time you're hearing that your plan is gone.  The government shut down the company over allegations of insurance fraud.

The FBI and agents with the U.S. Department of Health and Human Services swept into the St. Petersburg office on Thursday. For two days, they pulled out boxes of files and computer information.  

Universal Health Care sold government-approved "Medicare Advantage" plans. It included supplemental coverage for senior citizens with Medicare.

Company founder Dr. Akshay Desai told FOX News he denies any wrongdoing.  He said, "The company has and is continuing to behave in an ethical and legal fashion."

In the meantime, this is a big, expensive problem for people like Larry Krassner.  He finds peace in his Hall County backyard in between taxing chemotherapy treatments.   But on April 1, he got an unsettling call at home telling him that the treatment center wanted to know how he planned to pay for his next round of chemo.

Mr. Krassner is covered by Medicare, but he used Universal Health Care's supplemental coverage to fill in some of the financial gaps.  He had just met his out-of-pocket maximum of $6,700, which meant his next treatment would be 100 percent covered.  Now, he says, he has to start all over.

You see, because he had to sign up with a new insurance plan on April 1, he won't be covered until May.  Had he signed up one day before, he would have had coverage.   He says he has never received any notice from his healthcare provider or Medicare services.

And what's more, when he does have full coverage next month, he has to pay out of pocket $6,700 one more time.   And like thousands of other Georgians, that puts a pinch in a fixed income.  

On Tuesday night, the FOX 5 I-Team was contacted by The Centers for Medicare and Medicaid Services.  They tell us they've negotiated with a new provider to cover Mr. Krassner now-- not making him wait until next month. It's good timing as he just found out about this issue on Monday, and his next chemo treatment is today.   What we don't know yet is whether he'll have to pay out of pocket $6,700 again.

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