The Centers for Medicare and Medicaid Services is freezing enrollment in Elevance Health's Medicare Advantage-Prescription Drug Plans for alleged noncompliance with risk adjustment and data submission ...

CMS suspend enrollment into Elevance Medicare Advantage plans starting March 31 due to noncompliance with risk adjustment data requirements.

Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the company’s finances.

As a result of insurers “upcoding” patient diagnoses, the Centers for Medicare and Medicaid Services (CMS) overpaid Medicare Advantage (MA) by $50 billion (or 13 percent) in 2024, according to the ...

The U.S. Centers for Medicare and Medicaid Services alleges the Indianapolis-based health insurer has failed to properly submit required information to federal regulators since 2018.

The Biden administration finalized a proposal to raise Medicare Advantage payments by 3.32% in 2024, slightly above the 1% raise that it proposed. The final payment rule released Friday comes after an ...

For this audit, we reviewed one MA organization, Cigna-HealthSpring Life & Health Insurance Company, Inc. (Cigna), and focused on nine groups of high-risk diagnosis codes. Our objective was to ...

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate ...

By Sriparna Roy March 2 (Reuters) - The Centers for Medicare & Medicaid Services intends to impose sanctions that would suspend enrollment in Elevance Health's Medicare Advantage prescription drug ...

The Centers for Medicare and Medicaid Services has finalized risk adjustment policies in a final rule to prevent overpayments to Medicare Advantage Organizations. Studies and audits done separately by ...

On December 16, 2025, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) published the results of its audit of a Louisiana-based Medicare Advantage ...

"This conduct violates multiple statutory and regulatory requirements, including the obligation to submit accurate risk adjustment data through the required electronic systems, report and return ...