The insurer sued CMS Sept. 30, alleging the agency downgraded its star ratings “based upon a single phone call that lasted less than [10] minutes.” UnitedHealthcare says the call never connected to its call center.
In documents filed Oct. 15 and later unsealed, UnitedHealthcare alleged the agency ignored its claims that it received “disparate” treatment to Elevance Health. In January 2024, Elevance sued the agency over its star ratings for that year. One issue in the case was the inclusion of a “secret shopper” phone call Elevance said did not connect.
A judge eventually sided with Elevance Health. CMS later recalculated star ratings for every MA plan after courts ruled it improperly changed its methodology for calculating ratings.
In court documents, attorneys for UnitedHealthcare argued that because CMS eventually struck the phone call that Elevance alleged did not connect from its star rating, UnitedHealthcare should be treated the same.
The insurer alleged CMS “utterly ignored” the allegation it was being treated unfairly during the appeals process.
Becker’s has reached out to CMS for comment and will update this article if more information becomes available.
Several other insurers have sued to challenge CMS’ star ratings decisions for 2025. Centene also sued the agency, alleging the inclusion of one secret shopper call in its star rating cost it $73 million in bonus payments.
Humana, Elevance Health and BCBS Louisiana have also filed challenges to their star ratings.
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