Lexology November 27, 2024
The enormous impact of Medicare Stars Ratings on payments received by Medicare Advantage plans cannot be overstated. And with billions of dollars in bonus payments at stake, it may come as no surprise that stringent standards set out by the Centers for Medicare and Medicaid Services (CMS) have led plans to pushback against agency interpretations and seek judicial redress. We discuss the issues here.
Background
Medicare Advantage, also referred to as Part C, allows beneficiaries to receive coverage under a managed care model delivered through private insurers, known as Medicare Advantage (MA) plans or Medicare Advantage organizations (MAOs). Beneficiaries must elect to enroll in Medicare Advantage and can only do so during certain specified enrollment periods after establishing they are...
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