Grip, “CMS collects $342m in Medicare Advantage compliance dispute,” quotes Henry Norwood, Esq., 2-2-2026

Kaufman Dolowich’s Henry Norwood, San Francisco Partner, was quoted in a recent GRIP article examining CMS’s $342 million payment dispute with Elevance Health and what the agency’s enforcement action means for Medicare Advantage plan compliance.

Mr. Norwood explained in the article that “CMS allegedly raised concerns that various paid claims submitted during this seven-year period were not supported by medical documentation. The insurer responded by providing data corrections, but allegedly did so via a flash drive, which CMS rejected as what they deem to be unacceptable method of submission. According to CMS, this issue allegedly persisted or was never corrected, resulting in fines, with which Elevance does not agree.”

“This incident should put Medicare Advantage plans on notice that CMS will not permit risk adjust data submissions by unacceptable methods. Insurers should review their CMS data submission practices, establish clear guidelines for employees involved in data submission, and ensure all data is submitted in compliance with CMS’ requirements,” he added. “This recent fine should encourage Medicare Advantage insurers to look back at previously submitted data and properly submit any necessary data corrections to avoid similar penalties.”

Subscribers can read the full article here: CMS collects $342m in Medicare Advantage compliance dispute