June 11, 2024
Payers | Tea Leaves
  • The Centers for Medicare and Medicaid Services (CMS) must recalculate Anthem Blue Cross and Blue Shield of Georgia’s Medicare Advantage star ratings, a federal court ruled Friday. Parent company Elevance Health sued over its scores in December, alleging CMS did not follow proper procedures when it modified how it assesses quality and distributes bonus payments to the highest-performing Medicare Advantage plans. SCAN Health Plan won a similar case before the same court last week. The two rulings carry implications for every Medicare Advantage insurer because CMS applied the same process to all its ratings last year. (Article here)