Humana Inc. et al. v. Department of Health and Human Services et al.

Docket No.
4:24-cv-01004
District Court
Texas Northern

Goal

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

Litigation Content

Why this Matters:

A Medicare Advantage organization and a broker trade association allege that the defendants miscalculated 2025 star ratings in violation of the Administrative Procedure Act. Specifically, the plaintiffs allege that the agencies refused to provide data and reasoning to support a decline in star ratings and unfairly relied on dropped or incomplete call information. 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.

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Litigation Information

Current Status

Decision issued