Blue Cross and Blue Shield of Florida, Inc. et al. v. Department of Health and Human Services et al.

Docket No.
1:24-cv-03609
District Court
District of Columbia

Goal

  • Compel agency action
  • Declaration that agency action is unlawful
  • Vacate agency action

Litigation Content

Why This Matters:

Two Medicare Advantage organizations allege that part of the defendants’ regulation on star ratings violates the Administrative Procedure Act. Specifically, the plaintiffs argue that the government’s “extreme circumstances rule,” which addresses whether a plan’s star ratings can be adjusted in light of extreme and uncontrollable conditions, is improperly dependent on a federal declaration of a public health emergency. 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:

Medicare beneficiaries seeking information about Medicare Advantage plans rely on federal star ratings. Ensuring that these ratings are accurate and not inflated helps beneficiaries find affordable plans and avoid unnecessary expenses.

Litigation Information

Current Status

Decision issued