CMS withdraws appeal in UnitedHealth star ratings challenge

CMS has withdrawn its appeal of a judge’s decision directing the agency to increase UnitedHealthcare’s star ratings for its Medicare Advantage plans for 2025. 

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Attorneys for the agency filed a notice of appeal Jan. 21. The agency did not provide a reason for the filing. 

On Jan. 24, attorneys filed another notice stating the appeal had been withdrawn. 

In September, UnitedHealthcare filed a lawsuit in U.S. District Court for the Eastern District of Texas, disputing the inclusion of a secret-shopper phone call in its star ratings determination that the company said did not meet the requirements to be included. 

In November, Judge Jeremy Kernodle ruled in favor of UnitedHealthcare. In his decision, Mr. Kernodle wrote that CMS acted contrary to its guidelines by including the phone call in its star rating. The judge ordered the agency to recalculate UnitedHealth’s MA ratings without the disputed call. 

The agency upped the star ratings for several of UnitedHealthcare’s MA contracts after the challenge. It also revised the star ratings for several of Centene’s MA contracts. Centene also sued the agency, disputing the inclusion of secret shopper calls in its ratings. 

Becker’s has reached out to UnitedHealthcare for comment and will update this article if more information becomes available. 

Editor’s note: This article was published Jan. 22 and updated Jan. 24 to reflect that CMS has withdrawn its appeal. 

 

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