News Briefs: CMS Reportedly Plans to Redo MA Star Ratings

In light of recent court rulings, CMS said in a memo released on June 13 that it plans to recalculate the 2024 quality ratings of Medicare Advantage plans. Earlier this month, SCAN Health Plan won a legal challenge to CMS’s calculation of the 2024 Star Ratings in the U.S. District Court for the District of Columbia. That same court also ruled that CMS must recalculate Anthem Blue Cross and Blue Shield of Georgia’s MA Star Ratings. Elevance Health, Inc., the parent company of the Anthem Georgia plan, disclosed in March that CMS had updated its original ratings, which will lead to an additional $190 million in revenue for plan year 2025. In its memo, CMS wrote that it has recalculated the 2024 Star Ratings — which determine 2025 quality bonus payments (QBP) — using the published 2023 Star Ratings cut points. “We have assigned all contracts the recalculated 2024 overall and/or summary Star Ratings if those recalculated ratings result in higher QBP Ratings than what was previously assigned based on the contract’s overall and/or summary 2024 Star Ratings that were released in October 2023,” the agency said.

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AIS Health Staff

AIS Health Staff

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