CMS notifies Elevance Health it may suspend enrollment capabilities
By HME News Staff
Updated 12:52 PM CST, Tue March 3, 2026
WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) will suspend Elevance Health’s ability to enroll people in its Medicare Advantage plans if the insurer doesn’t comply with risk adjustment data submission requirements.
In a Feb. 27 letter to Elevance, CMS said sanctions would begin March 31 for Elevance’s “pattern of knowing noncompliance.”
In its letter, CMS states: 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. Instead, Elevance has repeatedly provided this information via encrypted external USB flash drives, a method that CMS has explicitly rejected. Despite repeated clear directives from CMS that encrypted files do not satisfy regulatory obligations, Elevance continued this practice as recently as October 10, 2025.
In a Form 8-K filing March 2, the company said it is engaging with CMS regarding the matter and is committed to working with CMS to address its concerns.
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