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 62 entries
Date Action Taken Organization Name Action Taken Basis for Action Effective Date
2022-11-30 Elevance Health Civil Money Penalty ($38,512) Contract Administration 2022-11-30
2022-11-30 Humana, Inc. Civil Money Penalty ($131,660) Contract Administration 2022-11-30
2022-11-30 Kaiser Foundation Health Plan, Inc. Civil Money Penalty ($27,260) Contract Administration 2022-11-30
2022-11-21 InnovAge California PACE – Sacramento, LLC Sanction Release Deficiencies Corrected 2022-11-21
2022-09-20 UnitedHealthcare Plan of the River Valley, Inc. Suspension of Enrollment Contract Administration 2022-09-20
2022-09-20 UnitedHealthcare of the Midwest, Inc. Sanction Release Deficiencies Corrected 2023-01-01
2022-09-20 UnitedHealthcare of Arkansas, Inc. Sanction Release Deficiencies Corrected 2023-01-01
2022-09-20 Triple S Advantage, Inc. Sanction Release Deficiencies Corrected 2023-01-01
2022-09-20 UnitedHealthcare of New Mexico, Inc. Sanction Release Deficiencies Corrected 2023-01-01
2022-09-20 MMM Healthcare, LLC Sanction Release Deficiencies Corrected 2023-01-01
Page Last Modified:
04/11/2022 11:55 AM