The same federal judge who ruled in favor of Clover Health in its request to recalculate its 2026 CMS Star Ratings is denying Elevance’s emergency request to recalculate its 2026 MA Star Ratings. The judge said the suit was too late and denied CMS’s request to dismiss it.
The judge states in the ruling that Elevance is “substantially likely to win on the merits” on its claims that “CMS unlawfully used the disputed measures” from the Clover case to determine Elevance’s 2026 MA Star Ratings. The suit will continue, but the outcome won’t directly affect Elevance’s 2027 MA plans heading into the upcoming Annual Enrollment.
The ruling will hopefully finalize the Elevance MA plans’ benefit documents and other enrollment materials for 2027. Agility encourages all Elevance MA agents to confirm the schedule for these materials if they haven’t received it yet.
Agility will continue to provide updates on this lawsuit as we receive them and will note any impacts these updates have on MA agents in 2027. The SCAN and Alignment lawsuits continue over their 2026 MA Star Ratings in the same court, arguing that the Clover ruling should apply to each of their 2026 ratings.
There’s no indication at this time when a ruling in each of these suits will be issued by the court. Agility will continue to monitor these lawsuits to provide MA agents with the latest updates and any impacts, as we receive them.
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As the insurance market changes, Agility draws on years of experience to help you deliver great service and grow your business. For all insurance questions or to connect with our Medicare, ACA, Group, ICHRA, and ancillary experts, contact our dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com.
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Three Medicare Advantage (MA) companies are suing CMS over its miscalculation of each company’s MA Star Ratings. Alignment, Elevance, and SCAN Health have each filed their own suits, stating that CMS is not following the full order of the Clover Health case decided last month.
Each company has its own arguments that CMS isn’t following the judge’s ruling in the Clover case regarding how CMS MA Star Ratings should be calculated. Each lawsuit states specific negative revenue impacts for each company due to the CMS Star Ratings miscalculations.
At this point, there’s no indication of a timeline for when each lawsuit will be decided or how quickly any judicial ruling will affect each company’s Star Ratings and revenue. Agility will continue to closely monitor these lawsuits to inform Medicare agents of the latest developments and their potential impact.
The Agility Difference
With the ongoing evolution of the insurance market, Agility empowers you to identify your defining characteristic through our team’s expertise, positioning you for growth. With Agility, you also get Dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com to answer any insurance questions and direct you to our Medicare, ACA, ICHRA, Group, and ancillary experts.
They can also add you to our weekly email list for tips and updates. Let Agility empower you to evolve your capabilities and capture the opportunities in 2026.
