Healthcare DIVE August 20, 2025
The Texas judge’s decision — which picked apart Elevance’s argument on mathematical grounds — is expected to cost Elevance $375 million, though the insurer could still appeal.
Dive Brief:
- Elevance has lost a legal bid to improve its Medicare Advantage quality ratings for 2025.
- On Monday, a Texas federal judge threw out the insurer’s suit and offered a biting indictment of Elevance’s legal argument, saying it relied on distorted math.
- The lower star ratings will cost Elevance at least $375 million in bonus payments and rebates.
Dive Insight:
Regulators determine star ratings through a complex series of calculations to tally up dozens of metrics related to access, plan communication, patient experience and outcomes, and more. The scores, which...
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