WASHINGTON D.C. — Elevance Health paid the Centers for Medicare & Medicaid Services (CMS) $342,209,085.30 via wire transfer on May 27, 2026. The payment followed an enforcement action initiated by CMS in February 2026 threatening to halt enrollments in Elevance Medicare Advantage plans unless the company corrected noncompliance with federal regulations.

Government lawyers disclosed the payment in a court filing on June 22, 2026. A company official confirmed the wire transfer in an email made part of the court file and stated the payment was related to the threatened enrollment ban. In an email to CMS staff, Elevance Health described the money as a “remittance of the total overpayment amount” estimated by government audits.

CMS characterized the company's actions as “substantial and persistent noncompliance” with federal regulations requiring accurate billing data and the return of overpayments. Elevance Health stated it was challenging the CMS enforcement action and called it “unprecedented.” Leslie Porras, a company spokesperson, said Elevance Health “continues to engage in constructive dialogue” with CMS. Porras added, “We remain optimistic that a resolution can be reached and value our longstanding relationship with CMS.”

David Meyers, an associate professor at the Brown University School of Public Health, called the payment “substantial” and “a step in the right direction” toward holding the industry accountable. Meyers stated, “It’s a big win for CMS to get that much.” He also said, “It remains to be seen whether this is a sea change.”

David Lipschutz, an attorney with the Center for Medicare Advocacy, said, “I’ve never heard of something like this before.” Lipschutz added that usually plans “seem to tie everything up and try to delay any repayment of anything for years.”

Matthew Fiedler, a health policy researcher at the Brookings Institution, stated, “The payment Elevance is making here is not trivial.” Fiedler said making a big dent in the overpayment problem would require CMS to collect “many similar payments” from “every” Medicare Advantage insurer. He further stated, “I don’t think there’s a clear reason to believe that at this stage.” Richard Kronick, a former federal health policy official and professor at the University of California-San Diego, described the action as reflecting “perhaps a bit of muscle flexing” by CMS to tighten up enforcement. Kronick said it was “still a sizable check to write.”

In an April 2026 filing with the Securities and Exchange Commission, Elevance Health noted its “current best estimate” of the “potential exposure” in the case was approximately $935 million. The Justice Department filed a False Claims Act lawsuit against Elevance Health, then known as Anthem, in 2020. That lawsuit is pending. Elevance Health has denied wrongdoing in defending against the Justice Department suit and argued that CMS knew about its billing practices for years without taking action. The company covers about 2 million people on Medicare.

Why It Matters

This payment by Elevance Health to CMS resulted from a federal enforcement action related to noncompliance with federal regulations. The action could affect how Medicare Advantage plans are regulated, particularly regarding accurate billing data and the return of overpayments. More than 35 million Americans, about 55% of people on Medicare, are enrolled in Medicare Advantage health insurance plans. The outcome of this enforcement action and the pending Justice Department lawsuit could set a precedent for how CMS addresses billing noncompliance within the broader Medicare Advantage industry.