A federal judge dismissed Humana’s Medicare Advantage 2025 star ratings lawsuit with prejudice Oct. 14, according to court documents.
After an earlier suit was dismissed in July, Humana filed a complaint to resurface its concerns with its star ratings. The initial lawsuit was dismissed without prejudice, which allowed the case to be reopened.
CMS evaluates call center operations as part of its assessment. Humana challenged the agency’s “secret shopper” calls that judge interpreter services.
“The agency’s determination is in accordance with its guidelines and is not arbitrary or capricious,” the most recent court documents said.
CMS star ratings lead to bonus payments for high-quality insurers. Last year, Humana’s ratings dropped significantly, prompting the lawsuit.
Humana was not alone in questioning its 2025 star ratings: Elevance Health and BCBS Louisiana also challenged their determinations.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
