Medicare Update: Major Insurer Sues Trump Admin Over Star Ratings
Summary
Alignment Healthcare, a large Medicare Advantage insurer, is suing the Trump administration over the 2027 star ratings given to its Medicare plans. The company argues that the Centers for Medicare & Medicaid Services (CMS) used improper methods to calculate these scores, which could cost Alignment over $200 million in 2028 payments.Key Facts
- Alignment Healthcare filed a lawsuit against CMS in federal court in Washington, D.C.
- The dispute concerns the 2027 Medicare Advantage star ratings, which dropped Alignment’s California HMO plan from 4 stars to 3.5 stars.
- Star ratings affect both plan quality comparisons for consumers and quality bonus payments to insurers.
- Alignment claims CMS used ten quality measures without proper rulemaking procedures required by law.
- The lower star ratings could reduce Alignment’s payments by more than $200 million in the year 2028.
- Alignment wants the court to void the 2027 ratings and force CMS to recalculate them without the disputed measures.
- The company says using “technical notes” instead of formal rulemaking breaks the Administrative Procedure Act.
- CMS released the 2027 star ratings on October 8, showing a big decrease in high-rated plans for Alignment members.
Read the Full Article
This is a fact-based summary from The Actual News. Click below to read the complete story directly from the original source.
