CMS has again suspended enrollment for two Medicare Advantage prescription drug plans offered by Boston-based eternalHealth, the second time in less than two years that the insurer has faced sanctions.
The agency said Aug. 27 the enrollment freeze on the two plans is based on its determination that eternalHealth’s conduct “poses a serious threat to enrollee health and safety.”
The sanction follows an Aug. 12 order from the Massachusetts Division of Insurance placing EternalHealth under administrative supervision and requiring the insurer to suspend new business until it meets certain financial requirements set by the state.
Because eternalHealth cannot accept new enrollments under its state license, CMS said it is out of compliance with its federal contract requirements. The enrollment freeze will remain in place until Massachusetts regulators confirm the company is back in good standing and the state order has been removed.
eternalHealth faced similar sanctions in 2025 after Massachusetts barred the insurer from marketing its products over financial solvency concerns. CMS lifted that sanction in September after the state withdrew its restrictions, but warned at the time that future noncompliance could result in additional sanctions, civil money penalties or contract termination.
The insurer has about 10,000 members across Massachusetts and Arizona, according to CMS data.
“eternalHealth has been in contact with CMS and is preparing a response,” a spokesperson for the insurer told Becker’s. “The company understands that CMS’ decision is the result of a communication from the Massachusetts Division of Insurance (DOI). Separately, eternalHealth is engaged with DOI on various fronts to address the concerns raised. It is eternalHealth’s goal to be able to enroll Medicare beneficiaries in its plans as soon as possible.”
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