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 67 entries
Date Action Taken Organization Name Action Taken Basis for Action Effective Date
2023-05-23 EmblemHealth, Inc. Civil Money Penalty ($116,288) Contract Administration 2023-05-23
2023-03-16 Imperial Health Plan of California Civil Money Penalty ($39,208) Contract Administration 2023-03-16
2023-03-16 Independence Health Group, Inc. Civil Money Penalty ($6,032) Contract Administration 2023-03-16
2023-03-16 Intermountain Health Care, Inc. Civil Money Penalty ($17,980) Contract Administration 2023-03-16
2023-02-22 Imperial Health Plan of California Termination Contract Administration 2023-12-31
2023-01-23 InnovAge Colorado PACE Sanction Release Deficiencies Corrected 2023-01-23
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
Page Last Modified:
02/14/2023 10:00 AM