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Monitor CMS Sanctions and Other Enforcement Actions

CMS has the authority to take enforcement or contract actions when CMS determines that a Medicare Plan Sponsor either:

  • Substantially fails to comply with program and/or contract requirements,
  • Is carrying out its contract with CMS in a manner that is inconsistent with the efficient and effective administration of the Medicare Part C and Part D program requirements, or
  • No longer substantially meets the applicable conditions of the Medicare Part C and D program.

Enforcement and contract actions include:

  • Civil money penalties (CMP)
  • Intermediate sanctions (i.e., suspension of marketing, enrollment, payment), and
  • Terminations.

Click Here for the list of recent CMP, Intermediate Sanction, and Termination notices issued by CMS.

Click Here to read the official CMS notice.


 

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