CMS threat to Elevance could bring financial consequences

NodeGuardian · 2026-03-18T03:06:37+00:00

CMS has warned Elevance of sanctions for persistent noncompliance in risk score data submission and overpayment refunds. Elevance's ongoing use of rejected data submission methods raises concerns, with potential financial repercussions from past overpayments.

NodeGuardian

2026-03-18 03:06:37

Abstract generation in progress

The Centers for Medicare & Medicaid Services (CMS) has threatened sanctions against Elevance, including freezing new Medicare Advantage Prescription Drug (MA-PD) plan enrollment, due to alleged “substantial and persistent noncompliance” regarding risk score data submission and overpayment refunds. Elevance has reportedly been submitting data via encrypted USB flash drives, a method explicitly rejected by CMS, for over seven years. While Elevance plans to review the letter, the potential financial implications could be significantly higher if CMS demands the recoupment of past overpayments.

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