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A growing wave of insurers is taking CMS to court over disputed 2027 Medicare Advantage star ratings. Centene is the latest, challenging 17 measures it says were calculated illegally — putting $448 million in bonus payments at risk. Alignment Healthcare and Healthfirst have filed similar suits, all arguing CMS bypassed proper rulemaking procedures.
A legal pile-up is forming against the Centers for Medicare & Medicaid Services (CMS) over its 2027 Medicare Advantage (MA) star ratings. Centene — the St. Louis-based insurer — became the third major health plan to sue CMS, challenging 17 of the measures used to calculate its quality scores. The insurer argues that CMS lacked the statutory authority to use these metrics and failed to follow proper notice-and-comment rulemaking, mirroring arguments that already succeeded in a spring ruling involving Clover Health, where a Georgia court struck down 20 measures.
The lawsuits reflect mounting frustration across the MA industry. Alignment Healthcare saw its share of members in 4-star-or-above plans fall from 98% to 25% year-over-year, while Centene's dropped from 16% to 12%. Despite the Clover ruling, CMS continued using some disputed measures for all other insurers — a decision the plaintiffs say is legally indefensible.
By the Numbers:
Why it matters: These lawsuits could force a sweeping recalculation of 2027 MA star ratings across the industry, reshaping hundreds of millions in insurer payments and raising deeper questions about whether the star ratings system — already criticized for not meaningfully improving plan quality — is fit for purpose.
