Centene Corporation has filed a lawsuit against the U.S. Department of Health and Human Services (HHS) regarding the calculation of Medicare Advantage Star Ratings for 2025. The company is challenging the methodology used by regulators, citing what it describes as 'systemic issues' with the Centers for Medicare and Medicaid Services (CMS) calculations.
Medicare Advantage Star Ratings are a critical component of health insurers' revenue, as they determine eligibility for quality bonus payments and influence member enrollment. A reduction in these ratings can lead to a significant financial impact for the company.
This legal action underscores Centene's commitment to ensuring fair and accurate assessments of its plan performance. The outcome of this lawsuit could have implications for Centene's Medicare Advantage business and potentially for the broader industry's interaction with CMS rating methodologies.
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