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