Lawsuits Target Troubled Medicare Managed Care Bonus Program

A pair of health insurer lawsuits have rekindled debate on whether to repair or replace a flawed bonus payment program for Medicare managed care plans.

Private Medicare Advantage insurers received an estimated $16 billion in quality bonus payments in 2023, according to the Medicare Payment Advisory Commission. That’s roughly five times the $3 billion that was paid in 2015, according to KFF. The bonus payments go to MA insurers that earn at least four of a possible five stars on a list of quality measures.

But after the Biden administration tweaked the methodology for calculating the 2024 star ratings, quality ...