Healthcare DIVE July 18, 2025
Civil monetary penalties against payers for improperly delaying or denying coverage, hitting members with higher cost-sharing than allowed and other issues have already surpassed $3 million this year.
Insurers offering Medicare Advantage and Medicare prescription drug plans were fined more money in the first four months of this year than in the past four years combined, according to a Healthcare Dive analysis of government data.
Civil monetary penalties against payers for improperly delaying or denying coverage, hitting members with higher cost sharing than allowed and other issues have already surpassed $3 million this year. That’s compared to less than $2 million in penalties in 2021 through 2024 combined, according to the data.
The CMS cautioned that the data shouldn’t be...
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