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CMS collects $342m in Medicare Advantage compliance dispute

A photo of a protest or demonstration with participants holding signs saying, "You Make Us Sick" and "Medicare Advantage is for Profit"
Photo: Alex Wong/Getty Images

A Big Three health insurer says it paid the fine to head off potential Medicare Advantage sanctions as it disputes the Centers for Medicare & Medicaid Services’ finding over alleged overpayments.

A major health payor has paid $342m to the Centers for Medicare & Medicaid Services (CMS) after the regulator warned the insurer that it could face sanctions related to Medicare Advantage (MA) compliance issues, according to public statements from the company and CMS.

The payment stems from a CMS determination

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