Judge dismisses Humana’s case over downgraded Medicare Advantage ratings

Bob Herman covers health insurance, government programs, hospitals, physicians, and other providers — reporting on how money influences those businesses and shapes what we all pay for care. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

A federal judge on Friday tossed out a lawsuit from Humana that attempted to reinstate higher quality ratings to its 2025 Medicare Advantage plans.

The ruling jeopardizes billions of dollars in taxpayer-funded bonuses that Humana gets from the government’s star ratings program. However, Humana said it is considering appealing or refiling the lawsuit, which was dismissed on administrative grounds.

U.S. District Court Judge Reed O’Connor said Humana’s lawsuit, filed in October, was “premature” because the company attempted to sue the government before it had gone through Medicare’s formal appeals process for contested star ratings. Medicare eventually denied Humana’s appeal in April, but O’Connor said existing case law requires courts to look at the alleged harms “at the time of the action brought.”