Blue Cross Suit Says US Made $35 Million Quality Rating Mistake

Blue Cross and Blue Shield of Massachusetts and its HMO subsidiary have sued the US health department over an alleged miscalculation of the company’s 2025 Medicare Advantage “star rating,” which could cost the insurer $35 million in bonus payments next year.

The lawsuit, filed in the US District Court for the District of Columbia on March 7, is the latest in a string of legal challenges that claim the Centers for Medicare & Medicaid Services acted in an “arbitrary and capricious” manner, violated federal law and its own regulations, and used flawed methodology to calculate and downgrade a Medicare Advantage ...