Medicare Advantage Plan Sues Agency Over Drop in Quality Rating

A Maryland-based Medicare Advantage insurer sued the Trump administration for allegedly reducing its quality rating due to errors made by the federal government and its contractor.

The complaint, filed Monday in the US District Court for the District of Columbia, claims the Centers for Medicare & Medicaid Services and its contractor Acumen LLC used the wrong data to calculate CareFirst’s quality rating score, a move that could lead the company to miss out on millions of dollars in potential bonus payments.

Star ratings, which range from one to five stars, play a crucial role for Medicare Advantage insurers. Higher ...