CMS will not take action on Elevance Health at this time
By HME News Staff
Updated 9:57 AM CDT, Mon June 1, 2026
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has notified Elevance Health that it will not impose intermediate sanctions on the insurer at this time. The agency says it is satisfied that Elevance has:
- Completed the initial submission in its established electronic systems (Risk Adjustment Processing System, the Encounter Data Processing System and the Risk Adjustment Overpayment Reporting module); and
- Remitted a wire transfer of the total overpayment amount based on all auditable estimates related to the matter.
CMS reminded Elevance that it has additional steps to take by June 30, 2026, to avoid intermediate sanctions effective July 1, 2026. Further, CMS says incomplete tasks and the following remaining tasks must be completed by July 31, 2026, to avoid intermediate sanctions effective Aug. 1, 2026:
- Resolving any issues raised during CMS technical assistance on RAOR submissions and any submission of additional overpayment amounts identified as a result of that technical assistance, including the upload to HPMS CAM of an updated spreadsheet as described in Appendix B: Remit the total overpayment;
- Resolving all rejections, errors, and edits identified by CMS on standard RAPS and EDPS reports; and
- Submitting Attestation 2.
Earlier this year, CMS said it would suspend Elevance’s ability to enroll people in its Medicare Advantage plans if the insurer didn’t comply with risk adjustment data submission requirements.
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