The U.S. Centers for Medicare & Medicaid Services (CMS) has suspended the marketing and enrollment activities of a New York-based company for not meeting the prescription drug needs of some of its members in 21 states.

Fox Insurance Co. of New York must stop the practices of its Medicare Part D prescription drug plans following complaints from plan members and physicians, according to CMS, which noted “serious threats” to the health and safety of many who qualify for the low-income subsidy under Part D.

The Fox plan is available in Arkansas, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Missouri, North Carolina, New Jersey, New York, Nevada, Ohio, Pennsylvania, South Carolina, Texas and West Virginia.

CMS said the Fox plan has failed to fully meet its obligations to Medicare beneficiaries, particularly new enrollees, by failing to provide timely access to Part D drugs by imposing prior authorization and step therapy requirements the agency did not approve. Fox also allegedly did not meet the necessary appeals deadlines or requirements to transition new enrollees to the covered drugs.

These failures, CMS noted, could result in improper delays in therapies and/or prevent access to medically necessary drugs and therapies. The threats to health and safety relate to Fox’s non-Medicare compliant coverage determinations involving protected class drugs and other needed drugs for the treatment of cancer, HIV/AIDS and seizure disorders, as well as drugs for diabetes and respiratory disease.

In a statement CMS said it will “closely monitor” the plan to determine that corrective actions have been taken and if Fox is not in compliance with Medicare requirements, penalties range from fines to possible termination of Fox’s contract with Medicare.

Fox officials did not immediately respond to a request for comment by IFAwebnews.com.