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Dive Insight:
CVS is the latest in a growing list of insurers turning to the courts in a bid to hike their 2027 MA star ratings, after the quality scores slipped for many operators, threatening the lucrative bonus payments and other competitive advantages the ratings represent.
To date, at least four other insurers — Alignment Healthcare, Healthfirst, SCAN Health Plan and Centene — have sued the government over their 2027 stars.
The lawsuits cite a judge’s ruling last spring in a case brought by insurer Clover Health alleging that 20 measures the CMS used to determine 2026 scores were illegal. However, the CMS still used half of the contested measures in calculating ratings for the coming year for every insurer except Clover.