Elevance sues CMS over recalculated Medicare Advantage star ratings
Elevance Health filed suit against the U.S. government on 1 July in federal court in the Southern District of Georgia, arguing that a redo of its 2026 Medicare Advantage quality ratings cost it roughly $115 million. Star ratings gauge plan quality and customer service; plans clearing certain thresholds earn taxpayer-funded bonuses and rebates, so small scoring changes carry large financial stakes.
The dispute traces to an earlier case brought by Clover Health, after which CMS reran 2026 scores and dropped 20 measures a judge said could not be counted. When regulators then recalculated ratings for other insurers, Elevance says they also removed measures on which the company had performed well, lowering its stars. The insurer wants the court to force CMS to rescore its plans using the same methodology applied to Clover.
The case is the latest in a run of insurer challenges to the ratings system, which has drawn suits from several large Medicare Advantage carriers as CMS tightens the formula. Each recalculation ripples through bonus payments the following year, giving insurers a strong incentive to litigate methodology changes.