Anthem hit with federal penalty over plan spending

MMM Healthcare, an Anthem subsidiary, was served a federal penalty by CMS for failing to hit the 85 percent premium spending threshold, banning it from select enrollments starting Jan. 1, 2022. 

The sanctions stem from MMM Healthcare failing to spend 85 percent of premium revenue on its Medicare Advantage members. 

Three UnitedHealthcare plans were also hit with sanctions by CMS.

Due to the sanctions, MMM Healthcare will not be able to enroll new members for 2022. Should it hit the 85 percent medical loss ratio threshold, it may be eligible for enrollment in 2023.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Top 40 articles from the past 6 months