‘A Very Big Deal’: UnitedHealth’s Star Ratings Court Win Has Industrywide Implications
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Nov 27, 2024
In a development that one expert calls a “huge victory for the industry,” a federal judge has ordered CMS to recalculate UnitedHealthcare’s 2025 Medicare Advantage Star Ratings without factoring in a lone “secret shopper” call that downgraded the ratings of several of the insurer’s plans. Wall Street analysts also predicted that the ruling could be a boon for one specific MA-focused insurer: Humana Inc., which filed a lawsuit against CMS for a similar issue.
In an opinion issued Nov. 22, Judge Jeremy Kernodle of the U.S. District Court for the Eastern District of Texas partially granted UnitedHealth’s motion for summary judgment, agreeing with the insurer that CMS violated the Administrative Procedure Act (APA) when it assigned a 4-star rating to the performance of UnitedHealth’s call center.
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