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.)