- Docket No.
- 1:26-cv-03550
- District Court
- District of Columbia
Goal
- Compel agency action
- Declaration that agency action is unlawful
- Vacate agency action
Issues
Litigation Content
Why This Matters:
Why This Matters:
A health insurer alleges that the Centers for Medicare & Medicaid Services (CMS) violated the Administrative Procedure Act in calculating 2027 star ratings for its Medicare Advantage plans. Citing a recent decision by a separate district court that invalidated the same measures, the insurer argues that this calculation violates the Administrative Procedure Act by including 10 measures that were not subject to notice-and-comment rulemaking requirements. This insurer has made similar arguments in a separate lawsuit over its 2026 star ratings; that lawsuit is ongoing. Star ratings, which are designed to assess a plan’s quality, affect whether a plan is eligible for the Medicare Advantage program and whether the plan can receive bonus payments.
Potential Impact:
Potential Impact:
Challenges to the Medicare Advantage star ratings methodology could undermine the program’s ability to accurately convey quality to consumers and fairly allocate significant financial incentives to health plans, potentially impacting beneficiary benefits and market competition.