Elevance Health sues CMS, claiming $115 million loss from disputed Medicare Advantage star rating recalculation

Elevance Health filed a lawsuit in the U.S. District Court for the Southern District of Georgia, alleging that the Centers for Medicare & Medicaid Services (CMS) recalculated its Medicare Advantage star ratings in a manner inconsistent with a recent court ruling.

The insurer says the disputed recalculation stripped it of roughly $115 million in bonuses and rebates that are tied to meeting quality thresholds under the star‑rating system.

The case underscores ongoing tensions over how Medicare Advantage quality metrics are applied, a process that directly influences payments to private health insurers.