42 C.F.R. § 422.750
Types of intermediate sanctions and civil money penalties
(a) The following intermediate sanctions may be imposed and will continue in effect until CMS is satisfied that the deficiencies that are the basis for the sanction determination have been corrected and are not likely to recur:
(1) Suspension of the MA organization's enrollment of Medicare beneficiaries.
(2) Suspension of payment to the MA organization for Medicare beneficiaries enrolled after the date CMS notifies the organization of the intermediate sanction.
(3) Suspension of communication activities to Medicare beneficiaries by an MA organization, as defined by CMS.
(b) CMS may impose civil money penalties as specified in 422.760.
Notes of Decisions
Cited in 3
cases (3 in the last 5 years), 2022–2025 · leading case: USA ex rel. Elizabeth Holt v. Medicare Medicaid Advisors, 115 F.4th 908 (8th Cir. 2024).
USA ex rel. Elizabeth Holt v. Medicare Medicaid Advisors, 115 F.4th 908 (8th Cir. 2024). “42 C.F.R. § 422.750 (a). Relator worked as an insurance agent for MMA from September 2015 through December 2016.”
Holt v. Medicare Medicaid Advisors, Inc., No. 4:18-cv-00860 (W.D. Mo. Aug. 22, 2022). “See 42 C.F.R. § 422.750 (a) (stating the sanctions that “may be imposed” include suspension of an organization’s ability to enroll Medicare beneficiaries, suspension of payment for beneficiaries enrolled after the date CMS notifies the organization of the sanction, and…”
Barrows v. Humana, Inc., No. 3:23-cv-00654 (W.D. Ky. Aug. 15, 2025). “2262 (‘[MAOs] may not mislead, confuse, or provide materially inaccurate information to current or potential enrollees’); 42 C.F.R. § 422.750 (CMS’s powers to take enforcement action against MAOs).”
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