Policy & oversight
CMS Barred a Puerto Rico Medicare Advantage Plan From Accepting New Members for 2027
The Centers for Medicare and Medicaid Services issued an enrollment suspension notice on September 3 prohibiting MMM Healthcare LLC from enrolling new Medicare Advantage beneficiaries under contract H7522 for contract year 2027. Existing members are not affected.
By the Goodsurance editorial teamSeptember 23, 2026
The Centers for Medicare and Medicaid Services issued a notice on September 3, 2026, barring MMM Healthcare LLC from accepting new Medicare Advantage enrollments under its prescription drug plan contract (H7522) for contract year 2027. CMS cited contract administration grounds as the basis for the action.
The sanction is classified as an intermediate enforcement measure, which means it restricts new enrollment while the underlying compliance issue is addressed but does not terminate the plan or disenroll current members. People already enrolled in the MMM Healthcare plan before September 3 are not affected by the notice and may remain in the plan.
CMS blocked a Puerto Rico Medicare Advantage plan from enrolling new members for 2027. Current members are not affected.
MMM Healthcare operates in Puerto Rico, where Medicare Advantage enrollment rates are among the highest in the United States. Puerto Rico beneficiaries enrolled in or considering MMM Healthcare for 2027 will not be able to join the plan through the upcoming Annual Enrollment Period unless CMS lifts the suspension first.
CMS maintains a public list of all Part C and Part D enforcement actions on its website. Intermediate sanctions, including enrollment suspensions, can be imposed when a plan is found to be in substantial noncompliance with Medicare Advantage program requirements. CMS can lift the suspension after determining the plan has come into compliance. The notice did not specify a timeline for resolution.
Other recent examples of CMS enrollment suspensions include actions taken against Elevance Health earlier in 2026 related to risk adjustment data submission requirements.
In plain words
The federal agency that runs Medicare has stopped a Medicare Advantage plan in Puerto Rico from taking new members. The plan is called MMM Healthcare. CMS sent the notice on September 3, 2026. People who are already in the plan can stay. The plan just cannot sign up new people for 2027. CMS said it was because of a contract rule problem. CMS can remove the block after the plan fixes the issue. No timeline was given.
Understand the basics first
Source: CMS
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