How One Secret Shopper Call Cost Elevance Health $190 Million

A single bungled phone call cost one of the largest US health insurance companies $190 million, the company is arguing in a lawsuit that highlights how dependent health insurers have become on US government programs.

The US Medicare program uses a five-star rating system intended to steer older Americans into plans that do a better job improving their health. Now Elevance Health Inc. is arguing that regulators used flawed methods to determine crucial ratings that send billions of public dollars each year to insurers operating private Medicare Advantage health plans for seniors. It said the US put too much weight ...