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Humana renews challenge to downgrade of US Medicare 'star' ratings
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Humana renews challenge to downgrade of US Medicare 'star' ratings
Jul 21, 2025 5:16 PM

July 21 (Reuters) - Humana on Monday filed a new

lawsuit over the U.S. government's reduction in the health

insurer's star ratings for government-backed Medicare plans,

after an earlier challenge was dismissed on technical grounds.

Humana, in the lawsuit in Fort Worth, Texas, federal court,

says the lower ratings could cause it to lose customers and

potentially billions of dollars in bonus payments from the

government, which would have been used to reduce premiums and

increase benefits for its members.

U.S. District Judge Reed O'Connor in Fort Worth dismissed

those claims last week, finding Humana had failed to exhaust all

of its out-of-court options to challenge the ratings.

In the new lawsuit, Humana says it has in recent months

exhausted an administrative appeals process, giving the insurer

standing to sue.

"A final Star Rating determines legal rights and

obligations, and legal consequences flow from them," the company

said.

The U.S. Department of Health and Human Services, which

oversees Medicare, did not immediately respond to a request for

comment.

Humana is one of the largest providers of Medicare Advantage

plans in the U.S., which are funded by the Medicare health

insurance program for seniors and some disabled people but

administered by private insurers.

The U.S. Centers for Medicare and Medicaid Services, which

is part of HHS, issues star ratings for the plans, from one to

five stars, to help beneficiaries choose.

Plans with higher star ratings receive higher payments from

the government if they keep costs below certain targets. Those

bonus payments can be worth hundreds of millions or billions of

dollars.

Humana first sued HHS in October, after CMS finalized the

2025 star ratings. Like the complaint that was dismissed by

O'Connor, Monday's lawsuit challenges the way the ratings were

calculated and seeks an order directing CMS to set aside

Humana's 2025 ratings and recalculate them.

(Reporting by Daniel Wiessner in Albany, New York and Diana

Novak Jones; Editing by Lincoln Feast.)

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