Healthcare DIVE October 21, 2024
Rebecca Pifer

It’s the latest in a string of lawsuits from health insurers scrambling to protect their prized quality scores and the money those ratings represent.

Dive Brief:

  • Humana is suing the HHS in a bid to reverse a precipitous drop in its valuable Medicare Advantage star ratings that could cause the payer to lose out on billions of dollars in revenue.
  • The lawsuit filed Friday in a Texas district court accuses federal regulators of acting in an arbitrary and capricious manner when calculating Humana’s quality scores for 2025.
  • Humana is asking the judge to vacate its scores and force the government to recalculate the ratings by mid-December, so the payer can factor any changes into plan bids for the 2026...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: Govt Agencies, HHS, Insurance, Medicare Advantage, Payer
Elevance Health 'considering options' following star ratings hit
Humana sues over 2025 Medicare Advantage Star Ratings
Senate report slams Medicare Advantage insurers for using predictive technology to deny claims
Who’s putting profits before patients now?
The Opportunity Costs of Medicare Advantage Plan Rebates

Share This Article