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...

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Topics: Govt Agencies, HHS, Insurance, Medicare Advantage, Payer
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