Elevance Health Amends Lawsuit Over Medicare Advantage Payments

A Medicare managed care provider amended its lawsuit against the federal government after an HHS official determined the department erred in penalizing the insurer based on a disputed “secret shopper” phone call.

In the amended complaint filed Thursday in the US District Court for the District of Columbia, attorneys for Elevance Health said a “Reconsideration Official” with the Centers for Medicare & Medicaid Services, “found that there was no evidence the call at issue failed due to actions by Elevance and should not have counted against Elevance.”

The CMS official, according to the filing, concluded that Elevance should have received ...