Humana Hit Hard: Judge Upholds Medicare Advantage Star Cut, Stock Slides
Humana sued CMS in July after its star rating unexpectedly plunged. The insurer argued that CMS unfairly flagged three interpreter calls as failures, causing a 4.5-to-3.5 star drop reuters.com healthcaredive.com. On Oct. 14, U.S. District Judge Reed O’Connor rejected Humana’s arguments reuters.com. He found that CMS had acted “in accordance with its guidelines” and did not act arbitrarily fiercehealthcare.com. In particular, the judge upheld CMS’s no-callbacks policy for those language-line test calls as lawful healthcaredive.com. The case was dismissed “with prejudice,” meaning Humana can’t refile the exact same lawsuit, though it could seek appeal healthcaredive.com. In short, the court has now twice sided with CMS on the merits. A Humana spokesperson said the company was “disappointed” but remains “committed to delivering meaningful improvements” and will consider further legal remedies reuters.com.