Elevance pays CMS $342M to assuage concerns of noncompliance and overbilling

July 2, 2026 - 07:10

Elevance Health has paid $342 million to the Centers for Medicare and Medicaid Services to address concerns about noncompliance and overbilling in its Medicare Advantage plans. The payment matches the total amount that a CMS audit identified as overpayments the company received for patient care services.

The insurer confirmed the payout, stating it is equal to what the federal audit determined was the excess amount paid to Elevance. However, CMS has not yet formally withdrawn its enforcement action against the company. The two sides remain in active negotiations to resolve the remaining issues.

Medicare Advantage plans are private insurance alternatives to traditional Medicare. They have faced increased scrutiny in recent years over billing practices, with federal audits frequently finding that insurers received more money than they were entitled to for the care they provided.

The payment from Elevance represents a significant step toward settling the dispute, but the lack of a final resolution means the case is not fully closed. Both parties continue discussions to finalize the terms of a broader agreement.