CMS proposes sanctions suspending Elevance Medicare Advantage enrollment over risk adjustment data issues

Elevance Health, Inc.

CMS notified Elevance of intent to impose sanctions suspending MA-PD enrollment and certain communications effective March 31, 2026 unless resolved.
Sanctions relate to alleged noncompliance with Medicare Advantage risk adjustment data submission requirements for dates of service prior to April 3, 2023.
Elevance revised practices in April 2023 following additional regulatory guidance; current MA-PD members' benefits and plans are unaffected.
Company is engaging with CMS and committed to addressing concerns cooperatively.

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