Code of Federal Regulations Title 42. Public Health § 42.423.2480 MLR review and non-compliance

(c)(1) Documents and records must be maintained for 10 years from the date such calculations were reported to CMS with respect to a given contract year.

(2) Part D sponsors must require any third party vendor supplying drug cost contracting and claim adjudication services to the Part D sponsors to provide all underlying data associated with MLR reporting to that Part D sponsor in a timely manner, when requested by the Part D sponsor, regardless of current contractual limitations, in order to validate the accuracy of MLR reporting.

(1) Are noted by CMS;

(2) Appropriate remittance amounts are recouped by CMS;  and

(3) Sanctions may be imposed by CMS as provided in § 423.752.