Carriers & the market
Centene Becomes Third Insurer to Sue CMS Over Its 2027 Medicare Advantage Star Ratings
Centene filed a federal lawsuit October 22 arguing that CMS applied 17 measures a court already struck down to every plan except the company that won in court, depressing its 2027 scores.
By the Goodsurance editorial teamOctober 27, 2026
Centene Corporation has become at least the third Medicare Advantage insurer to challenge its 2027 star ratings in federal court. The company filed suit on October 22 in the U.S. District Court for the Southern District of Georgia, naming the Department of Health and Human Services and CMS as defendants. Centene challenges 17 measures the agency used to calculate its scores.
The dispute has roots in a May 2026 ruling in Clover Insurance Co. v. HHS. In that case, the same court found that 20 measures CMS used to score Clover's 2026 plans violated the Administrative Procedure Act. When CMS released 2027 ratings on October 8, it dropped those measures only for Clover, leaving them in place for every other insurer. Centene argues that selective treatment is itself unlawful.
Three insurers have now sued CMS over 2027 Medicare Advantage star ratings, all arguing that measures a federal court struck down in one case are still being applied to everyone else.
Under the 2027 ratings, the share of Centene Medicare Advantage members enrolled in plans rated four stars or above fell from 16 percent in 2026 to 12 percent. Two Centene contracts received a low performance indicator, a label applied to plans that fall below three stars. Star ratings determine quality bonus payments, and lower bonuses can reduce the supplemental benefits a plan can offer.
Alignment Healthcare filed a similar lawsuit in October targeting 10 measures in its 2027 scores, and Healthfirst has challenged five measures in a separate action. CMS had not issued a public response to the Centene filing as of publication.
Beneficiaries shopping during open enrollment can view current star ratings for any plan at medicare.gov.
In plain words
A large insurance company called Centene sued the federal government this week over its Medicare Advantage grades for 2027. These grades are called star ratings. Higher ratings mean insurance companies get more bonus money from the government, which can help them offer extra benefits to members. Centene says the government used unfair rules to grade its plans. A court said those same rules were illegal earlier this year, but the government only stopped using them for the one company that went to court first. Two other insurance companies have filed similar lawsuits.
Understand the basics first
Source: Healthcare Dive
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