Source: Reuters
“The Centers for Medicare & Medicaid Services intends to impose sanctions that would suspend enrollment in Elevance Health’s Medicare Advantage prescription drug plans starting March 31, pushing the company’s shares down more than 3%. Elevance disclosed in a filing on Monday that CMS notified the health insurer on February 27 of its intention and indicated that the proposed sanctions relate to alleged non-compliance in submitting certain required risk-adjustment data for services provided before April 3, 2023 under the plans, which cover prescription drug costs for older adults. … 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 agency’s February 27 notice. Instead, Elevance has repeatedly provided this information via encrypted external USB flash drives, a method that the company has explicitly rejected.” (03/02/26)