SCAN Health Plan v. Department of Health and Human Services et al.

Why this Matters:

A Medicare Advantage organization alleges that the defendants miscalculated the 2024 star ratings for its Medicare Advantage plans in violation of the Administrative Procedure Act. Specifically, the plaintiff alleges that the Centers for Medicare and Medicaid Services inappropriately relied on inaccurate data and used a methodology that was not properly adopted. 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.