Part C and Part D Enforcement Actions https://www.cms.gov/rss/32011 Tue, 25 Feb 2025 22:11:45 -0500 Centers for Medicare and Medicaid ServicesMolinaCMP01172025Fri, 17 Jan 2025 11:37:01 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/molinacmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/molinacmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($67,976)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:36:44 -0500

organization_name: Molina Healthcare, Inc.

]]>ElevanceHealthCMP01172025Fri, 17 Jan 2025 11:31:24 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/elevancehealthcmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/elevancehealthcmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($149,060)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:30:24 -0500

organization_name: Elevance Health, Inc.

]]>CarleFoundationCMP01172025Fri, 17 Jan 2025 11:24:42 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/carlefoundationcmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/carlefoundationcmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($101,500)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:24:23 -0500

organization_name: The Carle Foundation

]]>MedcoCMP01172025Fri, 17 Jan 2025 11:19:46 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/medcocmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/medcocmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($32,364)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:18:59 -0500

organization_name: Medco Containment Life and Medco Containment NY

]]>BSWCMP01172025Fri, 17 Jan 2025 11:09:49 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bswcmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bswcmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($37,816)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:09:16 -0500

organization_name: Baylor Scott & White Holdings

]]>CenteneCMP01172025Fri, 17 Jan 2025 11:04:23 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/centenecmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/centenecmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($2,000,000)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 11:03:39 -0500

organization_name: Centene Corporation

]]>HumanaCMP01172025Fri, 17 Jan 2025 10:59:04 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/humanacmp01172025https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/humanacmp01172025action_basis: Contract Administration

action_taken: Civil Money Penalty ($99,064)

action_taken_date: Fri, 17 Jan 2025 00:00:00 -0500

effective_date: Fri, 17 Jan 2025 10:57:34 -0500

organization_name: Humana Inc.

]]>WellcareMOSanction09062024Fri, 06 Sep 2024 13:21:24 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcaremosanction09062024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcaremosanction09062024action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Fri, 06 Sep 2024 00:00:00 -0400

effective_date: Wed, 01 Jan 2025 00:00:00 -0500

organization_name: Wellcare of Missouri Health Insurance Company, Inc.

]]>CareImprovementPlusSanctionRelease09062024Fri, 06 Sep 2024 13:04:26 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/careimprovementplussanctionrelease09062024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/careimprovementplussanctionrelease09062024action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Fri, 06 Sep 2024 00:00:00 -0400

effective_date: Wed, 01 Jan 2025 00:00:00 -0500

organization_name: Care Improvement Plus South Central Insurance Co.

]]>PACE4DCSanction08232024Fri, 23 Aug 2024 13:17:01 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/pace4dcsanction08232024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/pace4dcsanction08232024action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Fri, 23 Aug 2024 00:00:00 -0400

effective_date: Sat, 24 Aug 2024 00:00:00 -0400

organization_name: PACE4DC, LLC

]]>ZingTermination-SanctionRetraction06252024Tue, 25 Jun 2024 15:58:40 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/zingtermination-sanctionretraction06252024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/zingtermination-sanctionretraction06252024action_basis: Contract Administration

action_taken: Termination Retraction

action_taken_date: Tue, 25 Jun 2024 00:00:00 -0400

effective_date: Tue, 25 Jun 2024 15:56:35 -0400

organization_name: Zing Health, Inc.

]]>FloridaPACESanction05172024Fri, 17 May 2024 14:10:30 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/floridapacesanction05172024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/floridapacesanction05172024action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Fri, 17 May 2024 00:00:00 -0400

effective_date: Sat, 18 May 2024 00:00:00 -0400

organization_name: PACE Partners of Northeast Florida, Inc.

]]>VillageSeniorServicesCMP03212024Thu, 21 Mar 2024 15:05:48 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/villageseniorservicescmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/villageseniorservicescmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($10,208)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 15:04:16 -0400

organization_name: Village Senior Services Corporation

]]>AstivaHealthCMP03212024Thu, 21 Mar 2024 14:31:07 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/astivahealthcmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/astivahealthcmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($6,380)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 14:30:25 -0400

organization_name: Astiva Health, Inc.

]]>CAPhysiciansServiceCMP03212024Thu, 21 Mar 2024 14:19:45 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/caphysiciansservicecmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/caphysiciansservicecmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($30,160)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 14:16:47 -0400

organization_name: California Physicians' Service

]]>BCBSMIMutualCMP03212024Thu, 21 Mar 2024 13:24:07 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bcbsmimutualcmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bcbsmimutualcmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($7,424)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 13:23:27 -0400

organization_name: Blue Cross Blue Shield of Michigan Mutual Insurance Company

]]>CapitalDistrictCMP03212024Thu, 21 Mar 2024 11:42:37 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/capitaldistrictcmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/capitaldistrictcmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($17,864)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 11:41:44 -0400

organization_name: Capital District Physicians' Health Plan, Inc.

]]>USAbleCMP03212024Thu, 21 Mar 2024 11:11:12 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/usablecmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/usablecmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($5,336)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 11:10:17 -0400

organization_name: USAble Mutual Insurance Company

]]>CareSourceCMP03212024Thu, 21 Mar 2024 10:54:58 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/caresourcecmp03212024https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/caresourcecmp03212024action_basis: Contract Administration

action_taken: Civil Money Penalty ($27,898)

action_taken_date: Thu, 21 Mar 2024 00:00:00 -0400

effective_date: Thu, 21 Mar 2024 10:52:57 -0400

organization_name: CareSource Ohio, Inc.

]]>WellCare of NC Termination-Sanction Notice 12272023Wed, 27 Dec 2023 15:35:31 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcare-nc-termination-sanction-notice-12272023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcare-nc-termination-sanction-notice-12272023action_basis: Contract Administration

action_taken: Termination

action_taken_date: Wed, 27 Dec 2023 00:00:00 -0500

effective_date: Wed, 27 Dec 2023 15:35:05 -0500

organization_name: WellCare Health Insurance of North Carolina, Inc.

]]>WellCare of AZ Termination-Sanction Notice 12272023Wed, 27 Dec 2023 15:31:26 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcare-az-termination-sanction-notice-12272023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/wellcare-az-termination-sanction-notice-12272023action_basis: Contract Administration

action_taken: Termination

action_taken_date: Wed, 27 Dec 2023 00:00:00 -0500

effective_date: Wed, 27 Dec 2023 15:30:39 -0500

organization_name: WellCare Health Insurance of Arizona, Inc.

]]>Zing Health Termination-Sanction 12272023Wed, 27 Dec 2023 15:26:51 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/zing-health-termination-sanction-12272023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/zing-health-termination-sanction-12272023action_basis: Contract Administration

action_taken: Termination

action_taken_date: Wed, 27 Dec 2023 00:00:00 -0500

effective_date: Wed, 27 Dec 2023 15:25:51 -0500

organization_name: Zing Health, Inc.

]]>UCareMinnesotaCMP12062023Wed, 06 Dec 2023 15:35:23 -0500https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/ucareminnesotacmp12062023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/ucareminnesotacmp12062023action_basis: Contract Administration

action_taken: Civil Money Penalty ($13,224)

action_taken_date: Wed, 06 Dec 2023 00:00:00 -0500

effective_date: Wed, 06 Dec 2023 15:33:39 -0500

organization_name: UCare Minnesota

]]>MedicaCMP11022023Thu, 02 Nov 2023 14:31:19 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/medicacmp11022023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/medicacmp11022023action_basis: Contract Administration

action_taken: Civil Money Penalty ($62,060)

action_taken_date: Thu, 02 Nov 2023 00:00:00 -0400

effective_date: Thu, 02 Nov 2023 14:29:24 -0400

organization_name: Medica Holding Company

]]>CenteneCMP11022023Thu, 02 Nov 2023 14:23:49 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/centenecmp11022023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/centenecmp11022023action_basis: Contract Administration

action_taken: Civil Money Penalty ($49,764)

action_taken_date: Thu, 02 Nov 2023 00:00:00 -0400

effective_date: Thu, 02 Nov 2023 14:23:00 -0400

organization_name: Centene Corporation

]]>BCBSRICMP11022023Thu, 02 Nov 2023 14:06:11 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bcbsricmp11022023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/bcbsricmp11022023action_basis: Contract Administration

action_taken: Civil Money Penalty ($24,940)

action_taken_date: Thu, 02 Nov 2023 00:00:00 -0400

effective_date: Thu, 02 Nov 2023 14:05:52 -0400

organization_name: Blue Cross & Blue Shield of Rhode Island

]]>AvMedCMP11022023Thu, 02 Nov 2023 13:56:38 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/avmedcmp11022023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/avmedcmp11022023action_basis: Contract Administration

action_taken: Civil Money Penalty ($5,336)

action_taken_date: Thu, 02 Nov 2023 00:00:00 -0400

effective_date: Thu, 02 Nov 2023 13:55:32 -0400

organization_name: AvMed, Inc.

]]>Clear Spring Termination-Sanction 10132023Mon, 16 Oct 2023 09:15:35 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/clear-spring-termination-sanction-10132023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/clear-spring-termination-sanction-10132023action_basis: Contract Administration

action_taken: Termination

action_taken_date: Fri, 13 Oct 2023 00:00:00 -0400

effective_date: Fri, 13 Oct 2023 09:13:54 -0400

organization_name: Clear Spring Health Insurance Company

]]>UHCRiverValleyRelease09192023Tue, 19 Sep 2023 10:56:46 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/uhcrivervalleyrelease09192023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/uhcrivervalleyrelease09192023action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 19 Sep 2023 00:00:00 -0400

effective_date: Mon, 01 Jan 2024 10:53:58 -0500

organization_name: UnitedHealthCare Plan of the River Valley, Inc.

]]>CareImprovementPlusSanction09192023Tue, 19 Sep 2023 10:35:49 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/careimprovementplussanction09192023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/careimprovementplussanction09192023action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Tue, 19 Sep 2023 00:00:00 -0400

effective_date: Tue, 19 Sep 2023 10:34:20 -0400

organization_name: Care Improvement Plus South Central Co.

]]>AultmanHealthCMP08072023Mon, 07 Aug 2023 16:05:27 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/aultmanhealthcmp08072023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/aultmanhealthcmp08072023action_basis: Contract Administration

action_taken: Civil Money Penalty ($162,632)

action_taken_date: Mon, 07 Aug 2023 00:00:00 -0400

effective_date: Mon, 07 Aug 2023 04:05:00 -0400

organization_name: Aultman Health Foundation

]]>EmblemHealthCMP08072023Mon, 07 Aug 2023 16:00:18 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/emblemhealthcmp08072023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/emblemhealthcmp08072023action_basis: Contract Administration

action_taken: Civil Money Penalty ($19,024)

action_taken_date: Mon, 07 Aug 2023 00:00:00 -0400

effective_date: Mon, 07 Aug 2023 04:00:00 -0400

organization_name: EmblemHealth, Inc.

]]>ModaHealthCMP08072023Mon, 07 Aug 2023 15:38:33 -0400https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/modahealthcmp08072023https://www.cms.gov//medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions/modahealthcmp08072023action_basis: Contract Administration

action_taken: Civil Money Penalty ($5,800)

action_taken_date: Mon, 07 Aug 2023 00:00:00 -0400

effective_date: Mon, 07 Aug 2023 04:00:00 -0400

organization_name: Moda Health Plan, Inc.

]]>EmblemHealthCMP05232023Tue, 23 May 2023 12:16:23 -0400https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/emblemhealthcmp05232023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/emblemhealthcmp05232023action_basis: Contract Administration

action_taken: Civil Money Penalty ($116,288)

action_taken_date: Tue, 23 May 2023 12:14:52 -0400

effective_date: Tue, 23 May 2023 12:00:00 -0400

organization_name: EmblemHealth, Inc.

]]>ImperialCMP03162023Thu, 16 Mar 2023 14:53:06 -0400https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/imperialcmp03162023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/imperialcmp03162023action_basis: Contract Administration

action_taken: Civil Money Penalty ($39,208)

action_taken_date: Thu, 16 Mar 2023 14:51:54 -0400

effective_date: Thu, 16 Mar 2023 12:00:00 -0400

organization_name: Imperial Health Plan of California

]]>IndependenceCMP03162023Thu, 16 Mar 2023 14:50:14 -0400https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/independencecmp03162023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/independencecmp03162023action_basis: Contract Administration

action_taken: Civil Money Penalty ($6,032)

action_taken_date: Thu, 16 Mar 2023 14:48:38 -0400

effective_date: Thu, 16 Mar 2023 12:00:00 -0400

organization_name: Independence Health Group, Inc.

]]>IntermountainCMP03162023Thu, 16 Mar 2023 14:46:52 -0400https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/intermountaincmp03162023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/intermountaincmp03162023action_basis: Contract Administration

action_taken: Civil Money Penalty ($17,980)

action_taken_date: Thu, 16 Mar 2023 14:45:22 -0400

effective_date: Thu, 16 Mar 2023 12:00:00 -0400

organization_name: Intermountain Health Care, Inc.

]]>ImperialTermination02222023Wed, 22 Feb 2023 14:04:35 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/imperialtermination02222023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/imperialtermination02222023action_basis: Contract Administration

action_taken: Termination

action_taken_date: Wed, 22 Feb 2023 14:02:47 -0500

effective_date: Sun, 31 Dec 2023 12:00:00 -0500

organization_name: Imperial Health Plan of California

]]>InnovAgeCORelease01232023Fri, 20 Jan 2023 09:49:38 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/innovagecorelease01232023https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/innovagecorelease01232023action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Mon, 23 Jan 2023 09:48:58 -0500

effective_date: Mon, 23 Jan 2023 12:00:00 -0500

organization_name: InnovAge Colorado PACE

]]>ElevanceCMP11302022Wed, 30 Nov 2022 11:30:11 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/elevancecmp11302022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/elevancecmp11302022action_basis: Contract Administration

action_taken: Civil Money Penalty ($38,512)

action_taken_date: Wed, 30 Nov 2022 11:28:48 -0500

effective_date: Wed, 30 Nov 2022 12:00:00 -0500

organization_name: Elevance Health

]]>HumanaCMP11302022Wed, 30 Nov 2022 11:24:15 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/humanacmp11302022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/humanacmp11302022action_basis: Contract Administration

action_taken: Civil Money Penalty ($131,660)

action_taken_date: Wed, 30 Nov 2022 11:22:37 -0500

effective_date: Wed, 30 Nov 2022 12:00:00 -0500

organization_name: Humana, Inc.

]]>KaiserCMP11302022Wed, 30 Nov 2022 11:06:29 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/kaisercmp11302022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/kaisercmp11302022action_basis: Contract Administration

action_taken: Civil Money Penalty ($27,260)

action_taken_date: Wed, 30 Nov 2022 11:04:36 -0500

effective_date: Wed, 30 Nov 2022 12:00:00 -0500

organization_name: Kaiser Foundation Health Plan, Inc.

]]>InnovAgeCASanctionRelease11212022Mon, 21 Nov 2022 09:38:50 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecasanctionrelease11212022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecasanctionrelease11212022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Mon, 21 Nov 2022 09:36:34 -0500

effective_date: Mon, 21 Nov 2022 12:00:00 -0500

organization_name: InnovAge California PACE – Sacramento, LLC

]]>UHCRiverValleySanction09202022Tue, 20 Sep 2022 10:09:48 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcrivervalleysanction09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcrivervalleysanction09202022action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Tue, 20 Sep 2022 10:06:43 -0400

effective_date: Tue, 20 Sep 2022 12:00:00 -0400

organization_name: UnitedHealthcare Plan of the River Valley, Inc.

]]>UHCMidwestSanctionRelease09202022Tue, 20 Sep 2022 10:03:12 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcmidwestsanctionrelease09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcmidwestsanctionrelease09202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 20 Sep 2022 10:01:21 -0400

effective_date: Sun, 01 Jan 2023 12:00:00 -0500

organization_name: UnitedHealthcare of the Midwest, Inc.

]]>UHCArkansasSanctionRelease09202022Tue, 20 Sep 2022 09:37:17 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcarkansassanctionrelease09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcarkansassanctionrelease09202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 20 Sep 2022 09:35:02 -0400

effective_date: Sun, 01 Jan 2023 12:00:00 -0500

organization_name: UnitedHealthcare of Arkansas, Inc.

]]>TripleSSanctionRelease09202022Tue, 20 Sep 2022 09:19:34 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triplessanctionrelease09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triplessanctionrelease09202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 20 Sep 2022 09:18:24 -0400

effective_date: Sun, 01 Jan 2023 12:00:00 -0500

organization_name: Triple S Advantage, Inc.

]]>UHCNewMexicoSanctionRelease09202022Tue, 20 Sep 2022 09:13:10 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcnewmexicosanctionrelease09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/uhcnewmexicosanctionrelease09202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 20 Sep 2022 09:11:43 -0400

effective_date: Sun, 01 Jan 2023 12:00:00 -0500

organization_name: UnitedHealthcare of New Mexico, Inc.

]]>MMMHealthcareSanctionRelease09202022Tue, 20 Sep 2022 09:03:18 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/mmmhealthcaresanctionrelease09202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/mmmhealthcaresanctionrelease09202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 20 Sep 2022 09:00:14 -0400

effective_date: Sun, 01 Jan 2023 12:00:00 -0500

organization_name: MMM Healthcare, LLC

]]>FHCSDCMPNotice6152022RedactedWed, 15 Jun 2022 15:29:39 -0400https://www.cms.gov//https/cmsgov/medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/fhcsdcmpnotice6152022redactedhttps://www.cms.gov//https/cmsgov/medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/fhcsdcmpnotice6152022redactedaction_basis: Contract Administration

action_taken: Civil Money Penalty ($40,282)

action_taken_date: Wed, 15 Jun 2022 16:00:00 -0400

effective_date: Wed, 15 Jun 2022 12:00:00 -0400

organization_name: Family Health Centers of San Diego, Inc.

]]>AnthemCMP04052022Tue, 05 Apr 2022 09:47:48 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/anthemcmp04052022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/anthemcmp04052022action_basis: Contract Administration

action_taken: Civil Money Penalty ($19,186)

action_taken_date: Tue, 05 Apr 2022 09:45:59 -0400

effective_date: Tue, 05 Apr 2022 12:00:00 -0400

organization_name: Anthem Inc.

]]>CenteneCMP03222022Tue, 22 Mar 2022 11:11:26 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/centenecmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/centenecmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($88,192)

action_taken_date: Tue, 22 Mar 2022 11:09:55 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: Centene Corporation

]]>MolinaCMP03222022Tue, 22 Mar 2022 11:05:10 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/molinacmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/molinacmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($43,884)

action_taken_date: Tue, 22 Mar 2022 11:04:05 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: Molina Healthcare, Inc.

]]>CIGNACMP03222022Tue, 22 Mar 2022 10:49:03 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/cignacmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/cignacmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($85,436)

action_taken_date: Tue, 22 Mar 2022 10:47:32 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: CIGNA

]]>EmblemHealthCMP03222022Tue, 22 Mar 2022 10:42:05 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/emblemhealthcmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/emblemhealthcmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($106,325)

action_taken_date: Tue, 22 Mar 2022 10:40:58 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: EmblemHealth, Inc.

]]>BCBSTNCMP03222022Tue, 22 Mar 2022 10:33:59 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/bcbstncmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/bcbstncmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($142,676)

action_taken_date: Tue, 22 Mar 2022 10:32:47 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: BlueCross BlueShield of Tennessee

]]>GuidewellCMP03222022Tue, 22 Mar 2022 10:22:42 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/guidewellcmp03222022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/guidewellcmp03222022action_basis: Contract Administration

action_taken: Civil Money Penalty ($52,258)

action_taken_date: Tue, 22 Mar 2022 10:24:10 -0400

effective_date: Tue, 22 Mar 2022 12:00:00 -0400

organization_name: Guidewell Mutual Holding Corporation

]]>VibraHealthCMP02252022Fri, 25 Feb 2022 16:19:31 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vibrahealthcmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vibrahealthcmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($9,328)

action_taken_date: Fri, 25 Feb 2022 16:18:14 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: Vibra Health Plan, Inc.

]]>NetworkHealthCMP02252022Fri, 25 Feb 2022 16:14:39 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/networkhealthcmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/networkhealthcmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($11,236)

action_taken_date: Fri, 25 Feb 2022 16:13:03 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: Network Health Insurance Corporation

]]>GlobalHealthCMP02252022Fri, 25 Feb 2022 16:08:05 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/globalhealthcmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/globalhealthcmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($26,182)

action_taken_date: Fri, 25 Feb 2022 16:04:52 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: Global Health Inc.

]]>IndependenceCMP02252022Fri, 25 Feb 2022 15:57:08 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/independencecmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/independencecmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($26,500)

action_taken_date: Fri, 25 Feb 2022 15:55:48 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: Independence Health Group, Inc.

]]>CaresourceCMP02252022Fri, 25 Feb 2022 15:46:16 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/caresourcecmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/caresourcecmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($66,250)

action_taken_date: Fri, 25 Feb 2022 15:44:39 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: CareSource Ohio Inc.

]]>CIGNACMP02252022Fri, 25 Feb 2022 15:40:00 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/cignacmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/cignacmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($126,988)

action_taken_date: Fri, 25 Feb 2022 15:38:28 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: CIGNA

]]>ParamountCareCMP02252022Fri, 25 Feb 2022 15:27:36 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/paramountcarecmp02252022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/paramountcarecmp02252022action_basis: Contract Administration

action_taken: Civil Money Penalty ($146,068)

action_taken_date: Fri, 25 Feb 2022 15:25:55 -0500

effective_date: Fri, 25 Feb 2022 12:00:00 -0500

organization_name: Paramount Care Inc.

]]>CaliforniaPhysiciansServiceCMP02242022Thu, 24 Feb 2022 10:54:31 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/californiaphysiciansservicecmp02242022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/californiaphysiciansservicecmp02242022action_basis: Contract Administration

action_taken: Civil Money Penalty ($40,282)

action_taken_date: Thu, 24 Feb 2022 10:52:46 -0500

effective_date: Thu, 24 Feb 2022 12:00:00 -0500

organization_name: California Physicians' Service

]]>VitalityHealthSanctionRelease01202022Wed, 19 Jan 2022 13:52:16 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vitalityhealthsanctionrelease01202022https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vitalityhealthsanctionrelease01202022action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Thu, 20 Jan 2022 09:44:00 -0500

effective_date: Tue, 04 Jan 2022 12:00:00 -0500

organization_name: Vitality Health Plan of California, Inc.

]]>InnovageCOSanctionRD12222021Wed, 22 Dec 2021 11:39:52 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecosanctionrd12222021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecosanctionrd12222021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Wed, 22 Dec 2021 11:38:56 -0500

effective_date: Wed, 22 Dec 2021 12:00:00 -0500

organization_name: InnovAge Colorado PACE

]]>ClearSpringHealthCMP12062021Mon, 06 Dec 2021 12:44:05 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/clearspringhealthcmp12062021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/clearspringhealthcmp12062021action_basis: Contract Administration

action_taken: Civil Money Penalty ($53,162)

action_taken_date: Mon, 06 Dec 2021 12:42:42 -0500

effective_date: Mon, 06 Dec 2021 12:00:00 -0500

organization_name: Clear Spring Health Insurance Company

]]>eternalHealthofDESanctionRelease12032021Mon, 06 Dec 2021 10:10:17 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/eternalhealthofdesanctionrelease12032021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/eternalhealthofdesanctionrelease12032021action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Fri, 03 Dec 2021 10:09:09 -0500

effective_date: Thu, 02 Dec 2021 12:00:00 -0500

organization_name: Eternal Health of Delaware, Inc.

]]>EternalHealthofDESanctionNotice10262021Tue, 26 Oct 2021 15:59:31 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/eternalhealthofdesanctionnotice10262021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/eternalhealthofdesanctionnotice10262021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Tue, 26 Oct 2021 16:00:00 -0400

effective_date: Wed, 27 Oct 2021 12:00:00 -0400

organization_name: Eternal Health of Delaware, Inc.

]]>ImperialAZSanctionRelease10072021Thu, 07 Oct 2021 11:12:57 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/imperialazsanctionrelease10072021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/imperialazsanctionrelease10072021action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Thu, 07 Oct 2021 16:00:00 -0400

effective_date: Tue, 05 Oct 2021 12:00:00 -0400

organization_name: Imperial Insurance Companies, Inc.

]]>InnovageCASanctionRD09172021Fri, 17 Sep 2021 12:19:14 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecasanctionrd09172021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/innovagecasanctionrd09172021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Fri, 17 Sep 2021 12:16:53 -0400

effective_date: Fri, 17 Sep 2021 12:00:00 -0400

organization_name: InnovAge California PACE – Sacramento, LLC

]]>UnitedoftheMidwestSanction09022021Thu, 02 Sep 2021 14:02:23 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofthemidwestsanction09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofthemidwestsanction09022021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Sep 2021 14:00:58 -0400

effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: UnitedHealthcare of the Midwest, Inc.

]]>UnitedofNewMexicoSanction09022021Thu, 02 Sep 2021 13:57:28 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofnewmexicosanction09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofnewmexicosanction09022021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Sep 2021 13:56:07 -0400

effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: UnitedHealthcare of New Mexico, Inc.

]]>UnitedofArkansasSanction09022021Thu, 02 Sep 2021 13:52:36 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofarkansassanction09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/unitedofarkansassanction09022021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Sep 2021 13:51:27 -0400

effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: UnitedHealthcare of Arkansas, Inc.

]]>Triple-SAdvantageSanction09022021Thu, 02 Sep 2021 13:46:57 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triple-sadvantagesanction09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triple-sadvantagesanction09022021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Sep 2021 13:46:05 -0400

effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: Triple-S Advantage, Inc.

]]>MMMHealthcareSanction09022021Thu, 02 Sep 2021 13:41:34 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/mmmhealthcaresanction09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/mmmhealthcaresanction09022021action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Sep 2021 13:40:11 -0400

effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: MMM Healthcare, LLC

]]>BlueCrossofIdahoSanctionRelease09022021Thu, 02 Sep 2021 13:30:57 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/bluecrossofidahosanctionrelease09022021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/bluecrossofidahosanctionrelease09022021effective_date: Thu, 02 Sep 2021 12:00:00 -0400

organization_name: Blue Cross of Idaho Care Plus, Inc.

]]>ImperialAZSanctionNotice06172021Thu, 17 Jun 2021 05:56:46 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/imperialazsanctionnotice06172021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/imperialazsanctionnotice06172021action_basis: Contract Administration

action_taken: Immediate Suspension of Enrollment

action_taken_date: Thu, 17 Jun 2021 16:00:00 -0400

effective_date: Thu, 17 Jun 2021 12:00:00 -0400

organization_name: Imperial Insurance Companies, Inc.

]]>GoldenStateSanction04292021Thu, 29 Apr 2021 09:36:05 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/goldenstatesanction04292021https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/goldenstatesanction04292021effective_date: Thu, 29 Apr 2021 12:00:00 -0400

organization_name: Golden State Medicare Health Plan

]]>SeniorLifeYorkSanctionRelease120820Tue, 08 Dec 2020 12:38:36 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/seniorlifeyorksanctionrelease120820https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/seniorlifeyorksanctionrelease120820effective_date: Tue, 08 Dec 2020 12:00:00 -0500

organization_name: Senior LIFE York, Inc.

]]>AnthemIncCMP111720Tue, 17 Nov 2020 10:27:26 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/antheminccmp111720https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/antheminccmp111720effective_date: Tue, 17 Nov 2020 12:00:00 -0500

organization_name: Anthem, Inc.

]]>CenteneCorpCMP111720Tue, 17 Nov 2020 10:13:18 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/centenecorpcmp111720https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/centenecorpcmp111720effective_date: Fri, 17 Nov 2017 12:00:00 -0500

organization_name: Centene Corporation

]]>CAREPLUSCMP111720Tue, 17 Nov 2020 10:02:42 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/carepluscmp111720https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/carepluscmp111720effective_date: Tue, 17 Nov 2020 12:00:00 -0500

organization_name: CarePlus Health Plans, Inc.

]]>MetroPlusCMP111720Tue, 17 Nov 2020 09:55:29 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/metropluscmp111720https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/metropluscmp111720effective_date: Tue, 17 Nov 2020 12:00:00 -0500

organization_name: MetroPlus Health Plan, Inc.

]]>LIFEPACECMPNotice102120Mon, 19 Oct 2020 16:09:50 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/lifepacecmpnotice102120https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/lifepacecmpnotice102120effective_date: Wed, 21 Oct 2020 12:00:00 -0400

organization_name: LIFE PACE

]]>Group1001SanctionRelease09222020Fri, 25 Sep 2020 13:13:50 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/group1001sanctionrelease09222020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/group1001sanctionrelease09222020effective_date: Tue, 22 Sep 2020 12:00:00 -0400

organization_name: Group 1001

]]>BlueCrossIdahoCarePlus09092020Thu, 10 Sep 2020 05:07:06 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcemen/bluecrossidahocareplus09092020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcemen/bluecrossidahocareplus09092020effective_date: Wed, 09 Sep 2020 12:00:00 -0400

organization_name: Blue Cross of Idaho Care Plus, Inc.

]]>Care Improvement Plus Sanction Release 09/01/2020Wed, 02 Sep 2020 05:30:25 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/care-improvement-plus-sanction-release-09012020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/care-improvement-plus-sanction-release-09012020effective_date: Tue, 01 Sep 2020 12:00:00 -0400

organization_name: Care Improvement Plus South Central Insurance Co

]]>CareNCareCMP07212020Tue, 21 Jul 2020 09:16:01 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/carencarecmp07212020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/carencarecmp07212020effective_date: Tue, 21 Jul 2020 12:00:00 -0400

organization_name: Care N' Care Insurance Company of North Carolina

]]>VitalityHealthSanction07022020Mon, 06 Jul 2020 05:13:42 -0400https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vitalityhealthsanction07022020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/vitalityhealthsanction07022020action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 02 Jul 2020 23:59:00 -0400

effective_date: Thu, 02 Jul 2020 12:00:00 -0400

organization_name: Vitality Health Plan of California, Inc.

]]>WellcareCMP02282020Fri, 28 Feb 2020 13:43:24 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/wellcarecmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/wellcarecmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: WellCare Health Plans, Inc.

]]>TuftsHealthCMP02282020Fri, 28 Feb 2020 13:36:09 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/tuftshealthcmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/tuftshealthcmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: Tufts Health Plan, Inc.

]]>TripleSCMP02282020Fri, 28 Feb 2020 13:31:54 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triplescmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/triplescmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: Triple-S Management Corporation

]]>HumanaCMP02282020Fri, 28 Feb 2020 13:27:40 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/humanacmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/humanacmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: Humana Inc.

]]>HCSCCMP02282020Fri, 28 Feb 2020 13:23:06 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/hcsccmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/hcsccmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: Health Care Service Corporation

]]>BlueShieldCACMP02282020Fri, 28 Feb 2020 13:19:03 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/blueshieldcacmp02282020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/blueshieldcacmp02282020effective_date: Fri, 28 Feb 2020 12:00:00 -0500

organization_name: Blue Shield of California Promise Health Plan

]]>DLICSanction01312020Mon, 03 Feb 2020 06:24:12 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/dlicsanction01312020https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/dlicsanction01312020effective_date: Fri, 31 Jan 2020 12:00:00 -0500

organization_name: Delaware Life Insurance Company

]]>SolisHealthPlanCMP1242019Mon, 09 Dec 2019 09:28:55 -0500https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/solishealthplancmp1242019https://www.cms.gov//medicarecompliance-and-auditspart-c-and-part-d-compliance-and-auditspartcandpartdenforcementactions/solishealthplancmp1242019effective_date: Wed, 04 Dec 2019 12:00:00 -0500

organization_name: Solis Health Plans, Inc.

]]>2019-09-11Mon, 04 Nov 2019 02:48:18 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/careimprovementplussanction091119https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/careimprovementplussanction091119effective_date: Wed, 11 Sep 2019 12:00:00 -0400

organization_name: Care Improvement Plus South Central Insurance Company

]]>2019-08-29Mon, 04 Nov 2019 02:48:13 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablesanctionrelease082919https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablesanctionrelease082919action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Thu, 29 Aug 2019 12:00:00 -0400

effective_date: Thu, 29 Aug 2019 12:00:00 -0400

organization_name: USAble Mutual Insurance Company

]]>2019-08-22Mon, 04 Nov 2019 02:48:12 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/seniorlifeyorksanctionrd082219https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/seniorlifeyorksanctionrd082219effective_date: Thu, 22 Aug 2019 12:00:00 -0400

organization_name: Senior LIFE York, Inc.

]]>2019-08-05Mon, 04 Nov 2019 02:48:11 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/wellcarecmp080519https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/wellcarecmp080519action_basis: Contract Administration

action_taken: Civil Money Penalty ($373,800)

action_taken_date: Mon, 05 Aug 2019 12:00:00 -0400

effective_date: Mon, 05 Aug 2019 12:00:00 -0400

organization_name: WellCare Health Plans, Inc.

]]>2019-06-27Mon, 04 Nov 2019 02:47:54 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/constellationtermination062719https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/constellationtermination062719action_basis: Contract Administration

action_taken: Termination

action_taken_date: Thu, 27 Jun 2019 12:00:00 -0400

effective_date: Thu, 27 Jun 2019 12:00:00 -0400

organization_name: Constellation Health, LLC

]]>2019-04-29Mon, 04 Nov 2019 02:47:38 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/franciscanalliancecmp042919https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/franciscanalliancecmp042919action_basis: Contract Administration

action_taken: Civil Money Penalty ($38,159)

action_taken_date: Mon, 29 Apr 2019 12:00:00 -0400

effective_date: Mon, 29 Apr 2019 12:00:00 -0400

organization_name: Franciscan ACO, Inc.

]]>2019-04-29Mon, 04 Nov 2019 02:47:38 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/communitypacecmp042919https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/communitypacecmp042919action_basis: Contract Administration

action_taken: Civil Money Penalty ($38,159)

action_taken_date: Mon, 29 Apr 2019 12:00:00 -0400

effective_date: Mon, 29 Apr 2019 12:00:00 -0400

organization_name: Community PACE at Home, Inc.

]]>2019-02-27Mon, 04 Nov 2019 02:47:25 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/santaclaracmp022719https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/santaclaracmp022719action_basis: Contract Administration

action_taken: Civil Money Penalty ($39,000)

action_taken_date: Wed, 27 Feb 2019 12:00:00 -0500

effective_date: Wed, 27 Feb 2019 12:00:00 -0500

organization_name: Santa Clara County Health Authority

]]>2019-03-06Mon, 04 Nov 2019 02:47:25 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/seniorlifelehighcmp030619redactedhttps://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/seniorlifelehighcmp030619redactedaction_basis: Contract Administration

action_taken: Civil Money Penalty ($38,159)

action_taken_date: Wed, 06 Mar 2019 12:00:00 -0500

effective_date: Wed, 06 Mar 2019 12:00:00 -0500

organization_name: Senior LIFE Lehigh Valley, Inc.

]]>2019-02-27Mon, 04 Nov 2019 02:47:21 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/nhpricmp022719https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/nhpricmp022719action_basis: Contract Administration

action_taken: Civil Money Penalty ($29,800)

action_taken_date: Wed, 27 Feb 2019 12:00:00 -0500

effective_date: Wed, 27 Feb 2019 12:00:00 -0500

organization_name: Neighborhood Health Plan of Rhode Island

]]>2019-03-12Mon, 04 Nov 2019 02:47:21 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/agewellcmp031219https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/agewellcmp031219action_basis: Contract Administration

action_taken: Civil Money Penalty ($39,200)

action_taken_date: Tue, 12 Mar 2019 12:00:00 -0400

effective_date: Tue, 12 Mar 2019 12:00:00 -0400

organization_name: Agewell New York, LLC

]]>2019-02-27Mon, 04 Nov 2019 02:47:18 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/commonwealthcmp022719https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/commonwealthcmp022719action_basis: Contract Administration

action_taken: Civil Money Penalty ($42,900)

action_taken_date: Wed, 27 Feb 2019 12:00:00 -0500

effective_date: Wed, 27 Feb 2019 12:00:00 -0500

organization_name: Commonwealth Care Alliance, Inc.

]]>2019-02-27Mon, 04 Nov 2019 02:47:16 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/arsuperiorselectcmp022719https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/arsuperiorselectcmp022719action_basis: Contract Administration

action_taken: Civil Money Penalty ($49,600)

action_taken_date: Wed, 27 Feb 2019 12:00:00 -0500

effective_date: Wed, 27 Feb 2019 12:00:00 -0500

organization_name: Arkansas Superior Select, Inc.

]]>2019-02-27Mon, 04 Nov 2019 02:47:15 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/localinitiativecmp02272019https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/localinitiativecmp02272019action_basis: Contract Administration

action_taken: Civil Money Penalty ($43,600)

action_taken_date: Wed, 27 Feb 2019 12:00:00 -0500

effective_date: Wed, 27 Feb 2019 12:00:00 -0500

organization_name: Local Initiative Health Authority of LA County

]]>2019-01-08Mon, 04 Nov 2019 02:46:59 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/centerlightcmp010819https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/centerlightcmp010819action_basis: Contract Administration

action_taken: Civil Money Penalty ($38,159)

action_taken_date: Tue, 08 Jan 2019 12:00:00 -0500

effective_date: Tue, 08 Jan 2019 12:00:00 -0500

organization_name: CenterLight TeamCare

]]>2018-11-08Mon, 04 Nov 2019 02:46:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/qhpsanction110818https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/qhpsanction110818action_basis: Contract Administration

action_taken: Suspension of Enrollment and Marketing

action_taken_date: Thu, 08 Nov 2018 12:00:00 -0500

effective_date: Thu, 08 Nov 2018 12:00:00 -0500

organization_name: QHP Financial Group, Inc.

]]>2018-10-17Mon, 04 Nov 2019 02:46:30 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/omahamutualrelease101718https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/omahamutualrelease101718action_basis: Deficiences Corrected

action_taken: Sanction Release

action_taken_date: Wed, 17 Oct 2018 12:00:00 -0400

effective_date: Wed, 17 Oct 2018 12:00:00 -0400

organization_name: Omaha Health Insurance Company

]]>2018-10-12Mon, 04 Nov 2019 02:46:29 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/omahamutualsanction101218https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/omahamutualsanction101218action_basis: Contract Administration

action_taken: Immediate Suspension of Enrollment and Marketing

action_taken_date: Fri, 12 Oct 2018 12:00:00 -0400

effective_date: Fri, 12 Oct 2018 12:00:00 -0400

organization_name: Omaha Health Insurance Company

]]>2018-09-18Mon, 04 Nov 2019 02:46:24 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/viachristisanctionrelease091818https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/viachristisanctionrelease091818action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Tue, 18 Sep 2018 12:00:00 -0400

effective_date: Tue, 18 Sep 2018 12:00:00 -0400

organization_name: Via Christi Healthcare Outreach for Elders, Inc.

]]>2018-09-20Mon, 04 Nov 2019 02:46:19 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablesuspension092018https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablesuspension092018action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Thu, 20 Sep 2018 12:00:00 -0400

effective_date: Thu, 20 Sep 2018 12:00:00 -0400

organization_name: USAble Mutual Insurance Company

]]>2018-07-26Mon, 04 Nov 2019 02:46:02 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/baylorscottwhitecmp072618-https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/baylorscottwhitecmp072618-action_basis: Contract Administration

action_taken: Civil Money Penalty ($40,000)

action_taken_date: Thu, 26 Jul 2018 12:00:00 -0400

effective_date: Thu, 26 Jul 2018 12:00:00 -0400

organization_name: Baylor Scott & White Holdings

]]>2018-06-18Mon, 04 Nov 2019 02:45:52 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/riversiderelease061818https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/riversiderelease061818action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Mon, 18 Jun 2018 12:00:00 -0400

effective_date: Mon, 18 Jun 2018 12:00:00 -0400

organization_name: Riverside Health System

]]>2018-05-09Mon, 04 Nov 2019 02:45:31 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/anthemcmp050918https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/anthemcmp050918action_basis: Contract Administration

action_taken: Civil Money Penalty ($243,200)

action_taken_date: Wed, 09 May 2018 12:00:00 -0400

effective_date: Wed, 09 May 2018 12:00:00 -0400

organization_name: Anthem, Inc.

]]>2018-05-09Mon, 04 Nov 2019 02:45:24 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/mvpcmp05092018https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/mvpcmp05092018action_basis: Contract Administration

action_taken: Civil Money Penalty ($44,400)

action_taken_date: Wed, 09 May 2018 12:00:00 -0400

effective_date: Wed, 09 May 2018 12:00:00 -0400

organization_name: MVP Health Plan, Inc.

]]>2018-03-14Mon, 04 Nov 2019 02:44:55 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/meritcmp031418https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/meritcmp031418action_basis: Contract Administration

action_taken: Civil Money Penalty ($62,100)

action_taken_date: Wed, 14 Mar 2018 12:00:00 -0400

effective_date: Wed, 14 Mar 2018 12:00:00 -0400

organization_name: Merit Health Insurance Company

]]>2017-12-21Mon, 04 Nov 2019 02:44:49 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/baylorscottcmp122117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/baylorscottcmp122117action_basis: Contract Administration

action_taken: Civil Money Penalty ($39,300)

action_taken_date: Thu, 21 Dec 2017 12:00:00 -0500

effective_date: Thu, 21 Dec 2017 12:00:00 -0500

organization_name: Baylor Scott & White Holdings

]]>2018-02-06Mon, 04 Nov 2019 02:44:49 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/meritcmp020618https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/meritcmp020618action_basis: Contract Administration

action_taken: Civil Money Penalty ($1,368,200)

action_taken_date: Tue, 06 Feb 2018 12:00:00 -0500

effective_date: Tue, 06 Feb 2018 12:00:00 -0500

organization_name: Merit Health Insurance Company

]]>2018-02-21Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/henryfordcmp022118https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/henryfordcmp022118action_basis: Contract Administration

action_taken: Civil Money Penalty ($43,300)

action_taken_date: Wed, 21 Feb 2018 12:00:00 -0500

effective_date: Wed, 21 Feb 2018 12:00:00 -0500

organization_name: Henry Ford Health System

]]>2018-02-21Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ucaremncmp022118https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ucaremncmp022118action_basis: Contract Administration

action_taken: Civil Money Penalty ($61,500)

action_taken_date: Wed, 21 Feb 2018 12:00:00 -0500

effective_date: Wed, 21 Feb 2018 12:00:00 -0500

organization_name: UCare Minnesota

]]>2018-02-21Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/floridahcpcmp022118https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/floridahcpcmp022118action_basis: Contract Administration

action_taken: Civil Money Penalty ($23,800)

action_taken_date: Wed, 21 Feb 2018 12:00:00 -0500

effective_date: Wed, 21 Feb 2018 12:00:00 -0500

organization_name: Florida Health Care Plan, Inc.

]]>2018-02-21Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cambiacmp022118https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cambiacmp022118action_basis: Contract Administration

action_taken: Civil Money Penalty ($65,800)

action_taken_date: Wed, 21 Feb 2018 12:00:00 -0500

effective_date: Wed, 21 Feb 2018 12:00:00 -0500

organization_name: Cambia Health Solutions, Inc.

]]>2018-02-06Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/guidewellcmp020618https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/guidewellcmp020618action_basis: Contract Administration

action_taken: Civil Money Penalty ($30,900)

action_taken_date: Tue, 06 Feb 2018 12:00:00 -0500

effective_date: Tue, 06 Feb 2018 12:00:00 -0500

organization_name: Guidewell Mutual Holding Corporation(H1026, H2758, H5434, R3332, S5904)

]]>2017-12-11Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/iuhpcmp121117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/iuhpcmp121117action_basis: Contract Administration

action_taken: Civil Money Penalty ($41,300)

action_taken_date: Mon, 11 Dec 2017 12:00:00 -0500

effective_date: Mon, 11 Dec 2017 12:00:00 -0500

organization_name: Indiana University Health Plans, Inc.

]]>2017-11-27Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/kaisercmp112717https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/kaisercmp112717action_basis: Contract Administration

action_taken: Civil Money Penalty ($45,900)

action_taken_date: Mon, 27 Nov 2017 12:00:00 -0500

effective_date: Mon, 27 Nov 2017 12:00:00 -0500

organization_name: Kaiser Foundation Health Plan, Inc.

]]>2017-12-21Mon, 04 Nov 2019 02:44:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/vantagecmp122117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/vantagecmp122117action_basis: Contract Administration

action_taken: Civil Money Penalty ($98,500)

action_taken_date: Thu, 21 Dec 2017 12:00:00 -0500

effective_date: Thu, 21 Dec 2017 12:00:00 -0500

organization_name: Vantage Holdings, Inc.

]]>2017-09-13Mon, 04 Nov 2019 02:44:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/expressscriptscmp091317https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/expressscriptscmp091317action_basis: Contract Administration

action_taken: Civil Money Penalty ($213,000)

action_taken_date: Wed, 13 Sep 2017 12:00:00 -0400

effective_date: Wed, 13 Sep 2017 12:00:00 -0400

organization_name: Express Scripts Holding Company

]]>2017-11-27Mon, 04 Nov 2019 02:44:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/affinitycmp112717https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/affinitycmp112717action_basis: Contract Administration

action_taken: Civil Money Penalty ($35,300)

action_taken_date: Mon, 27 Nov 2017 12:00:00 -0500

effective_date: Mon, 27 Nov 2017 12:00:00 -0500

organization_name: Affinity Health Plan, Inc.

]]>2017-11-14Mon, 04 Nov 2019 02:44:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablecmp111417https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usablecmp111417action_basis: Contract Administration

action_taken: Civil Money Penalty ($67,500)

action_taken_date: Tue, 14 Nov 2017 12:00:00 -0500

effective_date: Tue, 14 Nov 2017 12:00:00 -0500

organization_name: USAble Mutual Insurance Company

]]>2017-10-31Mon, 04 Nov 2019 02:44:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/excelluscmp103117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/excelluscmp103117action_basis: Contract Administration

action_taken: Civil Money Penalty ($105,400)

action_taken_date: Tue, 31 Oct 2017 12:00:00 -0400

effective_date: Tue, 31 Oct 2017 12:00:00 -0400

organization_name: Excellus Health Plan, Inc.

]]>2017-12-11Mon, 04 Nov 2019 02:44:45 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/medicalmutualofohiocmp121117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/medicalmutualofohiocmp121117action_basis: Contract Administration

action_taken: Civil Money Penalty ($222,300)

action_taken_date: Mon, 11 Dec 2017 12:00:00 -0500

effective_date: Mon, 11 Dec 2017 12:00:00 -0500

organization_name: Medical Mutual of Ohio

]]>2017-12-11Mon, 04 Nov 2019 02:44:44 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/bcbsofalcmp121117https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/bcbsofalcmp121117action_basis: Contract Administration

action_taken: Civil Money Penalty ($27,000)

action_taken_date: Mon, 11 Dec 2017 12:00:00 -0500

effective_date: Mon, 11 Dec 2017 12:00:00 -0500

organization_name: BlueCross BlueShield of Alabama

]]>2017-11-14Mon, 04 Nov 2019 02:44:44 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/bcbsoftncmp111417https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/bcbsoftncmp111417action_basis: Contract Administration

action_taken: Civil Money Penalty ($74,400)

action_taken_date: Tue, 14 Nov 2017 12:00:00 -0500

effective_date: Tue, 14 Nov 2017 12:00:00 -0500

organization_name: BlueCross BlueShield of Tennessee

]]>2018-02-06Mon, 04 Nov 2019 02:44:44 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ssmcmp020618https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ssmcmp020618action_basis: Contract Administration

action_taken: Civil Money Penalty ($36,400)

action_taken_date: Tue, 06 Feb 2018 12:00:00 -0500

effective_date: Tue, 06 Feb 2018 12:00:00 -0500

organization_name: SSM Healthcare Corporation

]]>2017-12-20Mon, 04 Nov 2019 02:44:24 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/rhs_sanction_12-20-2017https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/rhs_sanction_12-20-2017action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Wed, 20 Dec 2017 12:00:00 -0500

effective_date: Wed, 20 Dec 2017 12:00:00 -0500

organization_name: Riverside Health System

]]>2017-11-14Mon, 04 Nov 2019 02:44:15 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/senior_life_cmp_11_14_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/senior_life_cmp_11_14_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($37,396)

action_taken_date: Tue, 14 Nov 2017 12:00:00 -0500

effective_date: Tue, 14 Nov 2017 12:00:00 -0500

organization_name: Senior LIFE York, Inc.

]]>2017-09-26Mon, 04 Nov 2019 02:43:52 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usable_sanction_09-26-17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/usable_sanction_09-26-17action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Tue, 26 Sep 2017 12:00:00 -0400

effective_date: Tue, 26 Sep 2017 12:00:00 -0400

organization_name: USAble Mutual Insurance Company

]]>2017-10-03Mon, 04 Nov 2019 02:43:51 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/via_christi_sanction_10-03-2017https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/via_christi_sanction_10-03-2017action_basis: Contract Administration

action_taken: Suspension of Enrollment

action_taken_date: Tue, 03 Oct 2017 12:00:00 -0400

effective_date: Tue, 03 Oct 2017 12:00:00 -0400

organization_name: Via Christi Healthcare Outreach for Elders, Inc.

]]>2017-09-18Mon, 04 Nov 2019 02:43:47 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/premierhealthcmp_09-18-17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/premierhealthcmp_09-18-17action_basis: Contract Administration

action_taken: Civil Money Penalty ($3,600)

action_taken_date: Mon, 18 Sep 2017 12:00:00 -0400

effective_date: Mon, 18 Sep 2017 12:00:00 -0400

organization_name: Premier Health Insuring Corporation

]]>2017-07-14Mon, 04 Nov 2019 02:43:24 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/merit_health_cmp_7-14-17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/merit_health_cmp_7-14-17action_basis: Contract Administration

action_taken: Civil Money Penalty ($59,600)

action_taken_date: Fri, 14 Jul 2017 12:00:00 -0400

effective_date: Fri, 14 Jul 2017 12:00:00 -0400

organization_name: Merit Health Insurance Company

]]>2017-06-29Mon, 04 Nov 2019 02:43:21 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/fallon_cmp_notice_6_29_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/fallon_cmp_notice_6_29_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($344,100)

action_taken_date: Thu, 29 Jun 2017 12:00:00 -0400

effective_date: Thu, 29 Jun 2017 12:00:00 -0400

organization_name: Fallon Community Health Plan

]]>2017-06-21Mon, 04 Nov 2019 02:43:19 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/elderplan_cmp_6_21_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/elderplan_cmp_6_21_17action_basis: Required Beneficiary Notices

action_taken: Civil Money Penalty ($132,000)

action_taken_date: Wed, 21 Jun 2017 12:00:00 -0400

effective_date: Wed, 21 Jun 2017 12:00:00 -0400

organization_name: Elderplan, Inc.

]]>2017-06-21Mon, 04 Nov 2019 02:43:19 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/christus_cmp_6_21_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/christus_cmp_6_21_17action_basis: Required Beneficiary Notices

action_taken: Civil Money Penalty ($7,080)

action_taken_date: Wed, 21 Jun 2017 12:00:00 -0400

effective_date: Wed, 21 Jun 2017 12:00:00 -0400

organization_name: CHRISTUS Health Plan

]]>2017-06-16Mon, 04 Nov 2019 02:43:17 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cigna_sanction_release_06_16_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cigna_sanction_release_06_16_17action_basis: Deficiencies Corrected

action_taken: Sanction Release

action_taken_date: Fri, 16 Jun 2017 12:00:00 -0400

effective_date: Fri, 16 Jun 2017 12:00:00 -0400

organization_name: Cigna-HealthSpring

]]>2016-10-11Mon, 04 Nov 2019 02:42:46 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hcsc_cmp_notice_10_11_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hcsc_cmp_notice_10_11_16action_basis: Contract Administration

action_taken: Civil Money Penalty ($115,625)

action_taken_date: Tue, 11 Oct 2016 12:00:00 -0400

effective_date: Tue, 11 Oct 2016 12:00:00 -0400

organization_name: Health Care Service Corporation

]]>2017-02-24Mon, 04 Nov 2019 02:42:46 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ccok_cmp_02_24_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ccok_cmp_02_24_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($760,500)

action_taken_date: Fri, 24 Feb 2017 12:00:00 -0500

effective_date: Fri, 24 Feb 2017 12:00:00 -0500

organization_name: Community Care HMO, Inc.

]]>2017-02-24Mon, 04 Nov 2019 02:42:44 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/scan_cmp_notice_02_24_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/scan_cmp_notice_02_24_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($127,950)

action_taken_date: Fri, 24 Feb 2017 12:00:00 -0500

effective_date: Fri, 24 Feb 2017 12:00:00 -0500

organization_name: SCAN Health Plan

]]>2017-02-23Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/wellcare_cmp_notice_02_23_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/wellcare_cmp_notice_02_23_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($1,174,300)

action_taken_date: Thu, 23 Feb 2017 12:00:00 -0500

effective_date: Thu, 23 Feb 2017 12:00:00 -0500

organization_name: WellCare Health Plans, Inc.

]]>2016-11-21Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hpp_cmp_notice_11_21_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hpp_cmp_notice_11_21_16action_basis: Contract Administration

action_taken: Civil Money Penalty ($32,600)

action_taken_date: Mon, 21 Nov 2016 12:00:00 -0500

effective_date: Mon, 21 Nov 2016 12:00:00 -0500

organization_name: Health Partners Plans, Inc.

]]>2016-11-21Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/caidan_cmp_notice_11_21_2016https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/caidan_cmp_notice_11_21_2016action_basis: Contract Administration

action_taken: Civil Money Penalty ($57,715)

action_taken_date: Mon, 21 Nov 2016 12:00:00 -0500

effective_date: Mon, 21 Nov 2016 12:00:00 -0500

organization_name: Caidan Enterprises, Inc.

]]>2017-02-24Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ph_cmp_notice_02_24_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/ph_cmp_notice_02_24_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($83,250)

action_taken_date: Fri, 24 Feb 2017 12:00:00 -0500

effective_date: Fri, 24 Feb 2017 12:00:00 -0500

organization_name: Peoples Health, Inc.

]]>2016-11-21Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hp_of_san_mateo_cmp_11_21_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/hp_of_san_mateo_cmp_11_21_16action_basis: Contract Administration

action_taken: Civil Money Penalty ($49,725)

action_taken_date: Mon, 21 Nov 2016 12:00:00 -0500

effective_date: Mon, 21 Nov 2016 12:00:00 -0500

organization_name: Health Plan of San Mateo

]]>2017-01-12Mon, 04 Nov 2019 02:42:42 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/centene_cmp_01_12_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/centene_cmp_01_12_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($31,950)

action_taken_date: Thu, 12 Jan 2017 12:00:00 -0500

effective_date: Thu, 12 Jan 2017 12:00:00 -0500

organization_name: Centene Corporation

]]>2017-02-23Mon, 04 Nov 2019 02:42:41 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/fhc_cmp_notice_02_23_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/fhc_cmp_notice_02_23_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($28,975)

action_taken_date: Thu, 23 Feb 2017 12:00:00 -0500

effective_date: Thu, 23 Feb 2017 12:00:00 -0500

organization_name: FirstHealth of the Carolinas, Inc.

]]>2017-01-12Mon, 04 Nov 2019 02:42:41 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/avmed_cmp_notice_01_12_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/avmed_cmp_notice_01_12_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($764,375)

action_taken_date: Thu, 12 Jan 2017 12:00:00 -0500

effective_date: Thu, 12 Jan 2017 12:00:00 -0500

organization_name: AvMed, Inc.

]]>2016-11-22Mon, 04 Nov 2019 02:42:41 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/united_cmp_notice_11_22_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/united_cmp_notice_11_22_16action_basis: Contract Administration

action_taken: Civil Money Penalty ($2,498,850)

action_taken_date: Tue, 22 Nov 2016 12:00:00 -0500

effective_date: Tue, 22 Nov 2016 12:00:00 -0500

organization_name: UnitedHealthcare Medicare & Retirement

]]>2017-01-12Mon, 04 Nov 2019 02:42:41 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/presbyterian_cmp_01_12_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/presbyterian_cmp_01_12_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($775,375)

action_taken_date: Thu, 12 Jan 2017 12:00:00 -0500

effective_date: Thu, 12 Jan 2017 12:00:00 -0500

organization_name: Presbyterian Health Plan

]]>2017-02-23Mon, 04 Nov 2019 02:42:41 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/icare_cmp_notice_02_23_17https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/icare_cmp_notice_02_23_17action_basis: Contract Administration

action_taken: Civil Money Penalty ($321,900)

action_taken_date: Thu, 23 Feb 2017 12:00:00 -0500

effective_date: Thu, 23 Feb 2017 12:00:00 -0500

organization_name: Independent Care Health Plan, Inc.

]]>2016-10-11Mon, 04 Nov 2019 02:42:40 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/healthfirst_cmp_10_11_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/healthfirst_cmp_10_11_16action_basis: Contract Administration

action_taken: Civil Money Penalty ($38,125)

action_taken_date: Tue, 11 Oct 2016 12:00:00 -0400

effective_date: Tue, 11 Oct 2016 12:00:00 -0400

organization_name: Healthfirst, Inc.

]]>2016-01-21Mon, 04 Nov 2019 02:40:38 -0500https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cigna_sanction_01_21_16https://www.cms.gov//medicare/compliance-and-audits/part-c-and-part-d-compliance-and-audits/enforcement-letters-items/cigna_sanction_01_21_16action_basis: Contract Administration

action_taken: Immediate Suspension of Enrollment and Marketing

action_taken_date: Thu, 21 Jan 2016 12:00:00 -0500

effective_date: Thu, 21 Jan 2016 12:00:00 -0500

organization_name: Cigna-HealthSpring

]]>