Healthcare DIVE July 18, 2025
Analysts estimate Humana could lose billions of dollars as a result of the decision.
Dive Brief:
- A Texas federal judge has dismissed Humana’s lawsuit against the federal government seeking to improve its Medicare Advantage star ratings, in a significant loss for the insurer.
- Humana sued the CMS in October 2024 to reverse its quality scores, arguing that the agency acted arbitrarily and capriciously in downgrading the ratings, which are tied to billions of dollars in reimbursement, for 2025.
- However, District Judge Reed O’Connor ruled on Friday that Humana failed to exhaust administrative remedies before filing its lawsuit. Humana said it is exploring further legal action.
Dive Insight:
O’Connor’s decision, which sent Humana’s stock falling 3% on Friday morning,...
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