CMS Notifies Elevance Health Completed Step 2 of Corrective Action Plan

The Centers for Medicare & Medicaid Services notified Elevance Health that the company has completed Step 2 of its corrective action plan related to potential Medicare Advantage enrollment sanctions. In a letter dated May 29, CMS said it received Elevance's attestation confirming the company has submitted required data through the Risk Adjustment Processing System, Encounter Data Processing System, and the Risk Adjustment Overpayment Reporting module; remitted a wire transfer covering all auditable overpayment estimates, and uploaded supporting documentation, including overpayment IDs and estimates, to the Health Plan Management System's Compliance Activity Module. Based on the attestation, CMS said it will not impose intermediate sanctions at this time. However, the agency outlined two upcoming deadlines, namely June 30, when Elevance must complete Steps 3 and 4 of the corrective action plan to avoid sanctions taking effect July 1; and July 31 for the remaining Step 2 tasks - including resolving RAPS/EDPS errors, addressing issues identified during CMS technical assistance, and submitting a second attestation - must be completed to avoid sanctions effective August 1. CMS added that any unresolved items after these dates would trigger intermediate sanctions.