Elevance Loses Legal Challenge Over Medicare Quality Ratings

Elevance Health Inc. is set to miss out on hundreds of millions of dollars in bonus payments after a federal court found that the Medicare program didn’t err when it calculated the insurer’s 2025 quality ratings.

Judge Mark T. Pittman of the US District Court for the Northern District of Texas sided against Elevance’s argument that the Centers for Medicare & Medicaid Services failed to properly round up its 3.749565 star rating to 4 stars, leaving the insurer set to lose over $375 million in potential Medicare Advantage bonus payments next year.

Star ratings, which range from one to five ...