Elevance sues US government for $115M over Medicare Advantage star rating dispute

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Elevance Health has sued the U.S. government, alleging that federal efforts to recalculate its Medicare Advantage quality ratings didn’t align with a recent court ruling, costing the health insurer $115 million.

The lawsuit, filed Wednesday in U.S. District Court for the Southern District of Georgia, represents a new tier of drama in the Medicare Advantage program, which is the alternative to traditional Medicare that is run by private insurers.

The suit centers on star ratings, which are supposed to measure the quality of a health plan’s care and customer service. Plans that meet certain quality thresholds get extra taxpayer-funded bonuses and rebates.

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