Becker's Healthcare June 4, 2024
SCAN Health Plan has won its lawsuit against CMS that claimed the agency improperly calculated the payer’s 2024 Medicare Advantage star rating.
SCAN filed the suit in December after its star rating decreased from 4.5 to 3.5 — a move that could have led to about $250 million in missed quality bonus payments for the health plan and “at the heart” of why the company filed the lawsuit, according to its CEO Sachin Jain, MD.
“This decision reaffirms that star ratings actually matter,” Dr. Jain told Becker’s. “When there are these changes to the rules and how they’re implemented, real people are affected by that, in this case Medicare beneficiaries.”
In the June 3 ruling from the U.S. District Court...
Today's Sponsors
Today's Sponsor