CMS reworks Medicare Advantage star ratings after legal action

Bob covers the cash in well being care, specializing in medical insurance and hospitals. His tales delve into Medicare Benefit, opaque prescription drug advantages, and the way a lot executives truly make. He’s additionally the writer of the Well being Care Inc. publication. You possibly can attain Bob on Sign at bobjherman.09.

Federal officers have recalculated the standard scores for 2026 Medicare Benefit plans, a brand new authorities memo reveals. The consequential choice was prompted by one more authorized motion from the medical insurance business.

Over the previous few years, medical insurance firms that promote Medicare Benefit plans have inundated the Facilities for Medicare and Medicaid Providers with lawsuits that challenged their decrease star scores, which jeopardized taxpayer-funded bonuses. Many insurers have misplaced their circumstances, however a handful have received. Two years in the past, CMS needed to redo Medicare Benefit star scores after federal judges stated the federal government erred with its unique calculations.

Medicare Benefit plans that get no less than 4 out of 5 stars get bonus funds. These bonuses have ballooned to $16 billion this yr — virtually the complete funds of the Facilities for Illness Management and Prevention and an quantity that has doubled since 2020.