Elevance Health sues over Medicare Advantage star ratings amid Clover Health precedent
Elevance Health sued CMS over its refusal to recalculate star ratings after the Clover Health precedent, claiming the agency's handling will cost the insurer about $115 million in quality bonus payments.
Objective Facts
After a May 2026 federal court ruling that found 20 measures in CMS's 2026 star ratings calculation unlawful, CMS recalculated Clover Health's ratings while refusing to extend the same recalculation to other insurers. Elevance Health filed suit on July 1 in the U.S. District Court for the Southern District of Georgia, alleging that the agency's handling will cost the insurer about $115 million in 2027 quality bonus payments. According to Elevance's complaint, 10 measures were based on unauthorized data sources while another 10 lacked required notice-and-comment rulemaking. Instead of applying Clover's methodology broadly, CMS issued a June 17 memo to recalculate 2027 ratings for certain contracts using a different set of exclusions. Two weeks later, SCAN Health Plan and Alignment Healthcare filed separate lawsuits with identical arguments, with SCAN claiming $125 million in losses and Alignment claiming $50 million.
Deep Dive
The Clover Health precedent created a legal vulnerability that CMS attempted to manage through selective application. For Clover, CMS reran contracts without all 20 challenged measures, but for other plans, the agency removed some measures addressed in the Clover case, retained others, and cut some that weren't an issue in the lawsuit at all, including complaints against the health plan, metrics on members choosing to leave the plan, and whether a plan makes a foreign interpreter available for customer service. This approach gave Elevance reason to argue its case had merit—if one contract got the judge's ruling while others received the 'better of' a new CMS interpretation or the original rating, how could consistency be justified? Analysts noted that CMS's recalculation decision aligns with the Trump administration's goal of streamlining the star ratings program, suggesting administrative rather than purely legal motivations for the selective approach. However, watchdogs have become increasingly concerned about the star ratings program, especially given research showing it doesn't lead to improvements in plan quality and could be contributing to snowballing taxpayer spending on Medicare Advantage, with federal spending on bonuses expected to exceed $13 billion in 2026, higher than 2025 despite fewer beneficiaries in high-performing plans. The tension is genuine: applying Clover's methodology uniformly would mean larger payouts across the industry, yet refusing to do so invites litigation claiming regulatory inconsistency. The cascade of lawsuits signals the court's decision opened a door that CMS cannot easily close. All three insurers argue that recalculation is effectively required as part of the Clover decision if CMS is complying with the spirit of the ruling compelling the agency to evaluate plans with consistency. CMS faces a choice: expand the Clover recalculation methodology across the industry (costing hundreds of millions more in bonuses) or risk additional litigation on Administrative Procedure Act grounds.