Humana has reintroduced a lawsuit challenging its Medicare Advantage star ratings.
On July 18, U.S. District Judge Reed O’Connor dismissed the case without prejudice. Mr. O’Connor ruled that Humana had not exhausted all of its administrative appeal options when it first filed the case in October 2024.
Humana reintroduced the challenge July 21 in U.S. District Court in Fort Worth, Texas, saying it completed the administrative appeal process in April.
In its lawsuit, Humana argues CMS incorrectly administered “secret shopper” calls to evaluate Humana’s foreign language interpreter services. The insurer also argues CMS did not follow its own regulations in its methodology for calculating ratings, and alleged CMS did not provide Humana with necessary data to determine why star rating cut points moved upward for 2025.
Humana saw its star rating drop significantly from 2024 to 2025, and the company expects the lower ratings to hinder its 2026 earnings.
Several other insurers have challenged their 2025 star ratings in court. The cases have had mixed outcomes, with the court finding for UnitedHealthcare and Centene, while ruling against Florida Blue, Blue Cross Blue Shield of Louisiana and others.
In June, Humana CEO Jim Rechtin told investors the company is planning its MA strategy under the assumption that the company will lose its star ratings challenge.
