CMS recalculates Medicare Advantage star ratings again after insurer lawsuits
The Centers for Medicare and Medicaid Services has recalculated star ratings for 2026 Medicare Advantage plans after insurers challenged their scores in court — the second time in two years the agency has been forced to redo the figures. Major carriers including Elevance, Humana, UnitedHealth and Blue Cross Blue Shield plans have sued over lower ratings, and while many cases failed, enough succeeded to compel revisions.
The stakes are financial: plans that earn four or five stars qualify for taxpayer-funded bonus payments, which reached roughly $16 billion in 2026, about double their 2020 level. Because a fraction of a point can move a plan above or below the bonus threshold, insurers have a direct incentive to litigate any downgrade.
The pattern points to a structural problem in how the program rewards quality. When ratings that are supposed to measure plan performance can be reopened through litigation, the bonus system becomes less a consistent quality signal and more an outcome shaped by which carriers are willing to sue — adding volatility for insurers and uncertainty for the government’s payment calculations.