Healthcare DIVE November 14, 2024
Rebecca Pifer

Regulators’ assessment of customer support centers has spurred recent lawsuits from UnitedHealthcare, Centene and Humana.

Dive Brief:

  • The Biden administration is moving to lessen the importance of a controversial metric used to calculate valuable Medicare Advantage star ratings that’s been at the center of recent lawsuits.
  • UnitedHealthcare, Centene and Humana have all sued the government this fall for downgrading their quality scores based on assessments of their customer support centers. Payers argued the measure had an outsized impact on final star ratings, and it now seems regulators might agree.
  • “We have already put in place that [the call center metric] is going to have a smaller weighting on star ratings moving forward,” CMS Medicare Director Meena Seshamani said Wednesday...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage
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