Biden Medicare Team Plans to Tweak Disputed Quality Measure

The Biden administration is moving to lessen the impact of a problematic quality measure for Medicare managed care plans that has been the target of lawsuits in recent months.

A number of private Medicare Advantage insurers have sued the Centers for Medicare & Medicaid Services to contest their 2025 “star ratings,” which determine how much they’ll receive in 2026 from the Medicare Advantage Quality Bonus Payment program. The bonus payments, which can amount to hundreds of millions of dollars, go to MA insurers that earn at least four of a possible five stars on a list of quality measures.

Recent ...