Part C and Part D Enforcement Actions
CMS has the authority to take enforcement or contract actions when CMS determines that a Medicare Plan Sponsor either:
- substantially fails to comply with program and/or contract requirements,
- is carrying out its contract with CMS in a manner that is inconsistent with the efficient and effective administration of the Medicare Part C and Part D program requirements, or
- no longer substantially meets the applicable conditions of the Medicare Part C and D program.
Enforcement and contract actions include:
- Civil money penalties (CMP)
- Intermediate sanctions (i.e., suspension of marketing, enrollment, payment), and
- Terminations.
Below is a list of recent CMP, Intermediate Sanction, and Termination notices issued by CMS.
Showing 1-10 of 76 entries
| Date Action Taken | Organization Name | Action Taken | Basis for Action | Effective Date |
|---|---|---|---|---|
| 2021-10-26 | Eternal Health of Delaware, Inc. | Suspension of Enrollment | Contract Administration | 2021-10-27 |
| 2021-10-07 | Imperial Insurance Companies, Inc. | Sanction Release | Deficiencies Corrected | 2021-10-05 |
| 2021-09-17 | InnovAge California PACE – Sacramento, LLC | Suspension of Enrollment | Contract Administration | 2021-09-17 |
| 2021-09-02 | UnitedHealthcare of the Midwest, Inc. | Suspension of Enrollment | Contract Administration | 2021-09-02 |
| 2021-09-02 | UnitedHealthcare of New Mexico, Inc. | Suspension of Enrollment | Contract Administration | 2021-09-02 |
| 2021-09-02 | UnitedHealthcare of Arkansas, Inc. | Suspension of Enrollment | Contract Administration | 2021-09-02 |
| 2021-09-02 | Triple-S Advantage, Inc. | Suspension of Enrollment | Contract Administration | 2021-09-02 |
| 2021-09-02 | MMM Healthcare, LLC | Suspension of Enrollment | Contract Administration | 2021-09-02 |
| 2021-09-02 | Blue Cross of Idaho Care Plus, Inc. | Sanction Release | Deficiencies Corrected | 2021-09-02 |
| 2021-06-17 | Imperial Insurance Companies, Inc. | Immediate Suspension of Enrollment | Contract Administration | 2021-06-17 |
Page Last Modified:
12/01/2021 07:02 PM