CMS to Challenge Court Ruling on Medicare Star Ratings

January 24, 2025 - 01:58

The U.S. health agency, the Centers for Medicare & Medicaid Services (CMS), has declared its intention to appeal a ruling regarding the recalculation of Medicare Star Ratings, which was issued in November 2024. This decision comes in light of recent data revealing a significant drop in the performance ratings of Medicare Advantage plans for the upcoming year.

In October, it was reported that only about 40% of Medicare Advantage plans offering prescription drug coverage achieved four stars or higher for the 2025 ratings, a noticeable decrease compared to the previous year. The decline in ratings has raised concerns among beneficiaries and stakeholders in the healthcare sector. Notably, UnitedHealth managed to secure a four-star rating, but many other companies, including Humana, are facing substantial drops in their ratings.

The CMS's appeal reflects its commitment to ensuring that Medicare beneficiaries receive high-quality care and that the rating system accurately reflects the performance of these plans. The outcome of this appeal could have significant implications for Medicare Advantage providers and the millions of Americans who rely on these plans for their healthcare needs.