CMS lifts enrollment suspension on UnitedHealthcare Medicare Advantage plan

CMS has lifted an enrollment suspension on a UnitedHealthcare subsidiary's Medicare Advantage plan following three years of not meeting the required 85% medical loss ratio.

In September 2023, CMS suspended enrollment for one of Care Improvement Plus South Central's Medicare Advantage-Prescription Drug contracts for the 2024 plan year. The suspended Care Improvement Plus contract is only for employer group waiver plans owned by UnitedHealthcare.

In July 2024, Care Improvement Plus reported an MLR above 85% for the 2023 contract year, leading CMS to lift the enrollment suspension, effective January 1, 2025. The company has been able to offer the plan to new beneficiaries during the ongoing 2025 annual enrollment period. 

The plan could still face future enrollment suspensions if its MLR falls below 85% for another three consecutive years, according to CMS.

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