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 65 entries
Date Action Taken | Organization Name | Action Taken | Basis for Action | Effective Date |
---|---|---|---|---|
2020-12-07 | Senior LIFE York, Inc. | Sanction Release | Deficiencies Corrected | 2020-12-08 |
2020-11-17 | CarePlus Health Plans, Inc. | Civil Money Penalty ($100,806) | Contract Administration | 2020-11-17 |
2020-11-17 | Centene Corporation | Civil Money Penalty ($16,536) | Contract Administration | 2017-11-17 |
2020-11-17 | MetroPlus Health Plan, Inc. | Civil Money Penalty ($6,784) | Contract Administration | 2020-11-17 |
2020-11-17 | Anthem, Inc. | Civil Money Penalty ($318,975) | Contract Administration | 2020-11-17 |
2020-10-20 | LIFE PACE | Civil Money Penalty ($39,811) | Contract Administration | 2020-10-21 |
2020-09-22 | Group 1001 | Sanction Release | Deficiencies Corrected | 2020-09-22 |
2020-09-09 | Blue Cross of Idaho Care Plus, Inc. | Suspension of Enrollment | Contract Administration | 2020-09-09 |
2020-08-31 | Care Improvement Plus South Central Insurance Co | Sanction Release | Deficiencies Corrected | 2020-09-01 |
2020-07-21 | Care N' Care Insurance Company of North Carolina | Civil Money Penalty ($71,868) | Contract Administration | 2020-7-21 |
Page Last Modified:
02/28/2020 04:32 PM