Elevance Health filed a lawsuit against the U.S. government on November 4, 2024, challenging the calculation of Medicare Advantage star ratings for some of its government-backed plans. The company contends that improper rounding in the Centers for Medicare and Medicaid Services' (CMS) methodology cost it at least $375 million in bonus payments and rebates.
This legal action highlights a dispute over regulatory methodology with direct financial implications for the company's Medicare Advantage segment. A successful challenge could lead to the recovery of significant funds and positively impact future revenue.
The lawsuit aligns with other insurers who are also suing federal regulators over the 2025 quality ratings, indicating broader industry concerns regarding the fairness and accuracy of the current rating system.
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