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STAT+: Elevance sues government over $115 million tied to Medicare Advantage star ratings

Дата публикации: 02-07-2026 18:34:05

The health insurer says CMS didn't calculate its star ratings appropriately.

Основное содержимое страницы с новостью.

CMS’ recalculation of quality ratings wasn’t consistent with a recent court ruling, Elevance said
A sign of Elevance Health on headquarter building's glass exterior — business coverage from STAT Michael Conroy/AP

By Bob Herman

July 2, 2026

Bob Herman is the author of Health Care Inc., an award-winning weekly newsletter about the business of health and medicine.

Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

Elevance Health has sued the U.S. government, alleging that federal efforts to recalculate its Medicare Advantage quality ratings didn’t align with a recent court ruling, costing the health insurer $115 million.

The lawsuit, filed Wednesday in U.S. District Court for the Southern District of Georgia, represents a new tier of drama in the Medicare Advantage program, which is the alternative to traditional Medicare that is run by private insurers. 

The suit centers on star ratings, which are supposed to measure the quality of a health plan’s care and customer service. Plans that meet certain quality thresholds get extra taxpayer-funded bonuses and rebates. 

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  1. Business of Health Care Reporter

    Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

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