March 11, 2024
Payers | Tea Leaves
  • Elevance Health and its state-based subsidiaries initiated a lawsuit against the federal government last week demanding the Centers for Medicare and Medicaid Services (CMS) undo technical changes to the star ratings program, recalculate scores, and redetermine quality bonus payments. Elevance Health reported one of the largest ratings declines among large insurers last year, which it estimated will reduce revenue by $500 million in 2024. CMS also barred one of its plans from geographic expansion because of its low score. Health insurance companies protested the star ratings program modifications when CMS issued its regulations. The Elevance Health lawsuit reiterates some of the industry’s broad objections and makes specific claims about the agency’s allegedly unlawful administrative actions. (Article here)