This article is from: srnnews.com
March 2 (Reuters) – The Centers for Medicare & Medicaid Services has notified Elevance Health it plans to impose sanctions that would stop the health insurer from enrolling members in its Medicare Advantage prescription drug plans, a filing showed on Monday.
The sanctions are scheduled to take effect on March 31, 2026, unless the agency determines the issues identified have been satisfactorily addressed.
Shares of the company fell 3% in premarket trading.
CMS said the proposed sanctions relate to Elevance’s alleged noncompliance with certain Medicare Advantage risk adjustment data submission requirements.
Since November 13, 2018, Elevance has failed to submit data corrections for diagnosis codes it identified as unsupported by medical record documentation through CMS’s required electronic systems, according to the notice dated February 27.
Instead, Elevance has repeatedly provided this information via encrypted external USB flash drives, a method that CMS has explicitly rejected.
The agency said Elevance continued this practice as recently as October 10, 2025.
The health insurer said it had revised its practices in April 2023 and the suspension does not impact the company’s current members enrolled in the plans that cover prescription drug costs for older adults.
(Reporting by Sriparna Roy in Bengaluru; Editing by Krishna Chandra Eluri)
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