Medicare star ratings face lawsuits from 10 insurers, while published 2027 scores remain on Plan Finder for plan comparisons before the December 7 deadline. The litigation has widened since the first suits were reported, but no court ruling has changed the ratings displayed during Medicare open enrollment. For people comparing 2027 coverage, the published scores remain the available ratings. The lawsuits are about the calculation method and insurers’ future payments, not an automatic change to the plan terms listed for 2027.
Medicare Star Ratings Lawsuits: How the Litigation Expanded
The current wave involves roughly 10 to 11 insurers and health plan organizations, depending on how related cases and entities are counted. Available filings include CVS Health/Aetna, Centene, Elevance Health, Alignment Healthcare, SCAN Health Plan, Healthfirst, Blue Cross & Blue Shield of Rhode Island, Jefferson Health Plans, Verda Healthcare, Banner Health and Trinity Health.
The Georgetown Center on Health Insurance Reforms’ Health Care Litigation Tracker lists cases and filing dates. The timeline below summarizes the widening dispute. Reported dollar figures are estimates alleged by insurers, not confirmed losses or court-awarded amounts.
| Timing | Reported development |
|---|---|
| October 22 to 27 | Centene filed suit on October 22. CVS Health/Aetna’s suit followed, filed October 26 and reported publicly October 28. CVS alleged in its complaint that the ratings could increase its 2028 bonus payments and rebate retention by more than $2 billion, according to the complaint filed in federal court. |
| Late October and early November | Additional insurers, including Alignment Healthcare, SCAN and Healthfirst, challenged aspects of CMS’s 2027 ratings. Other filings followed in the same period. |
| November 3 to 6 | Blue Cross & Blue Shield of Rhode Island filed on November 3. Health Partners Plans filed November 4. Elevance Health and Banner Health filed on November 6. |
| November 6 to 11 | Elevance Health's complaint, filed November 6 in federal district court in Washington, alleges 11 measures were adopted without required rulemaking. It estimates approximately $516 million in 2028 bonus payments and rebate retention across 12 contracts. The tracker lists additional cases involving Verda Healthcare and others. |
The shared legal theory is that CMS allegedly used measures that were not adopted through required notice-and-comment rulemaking, or that exceeded the agency’s statutory authority. The complaints make allegations. They have not been established by a court ruling. The insurers’ claims about financial effects are also unproven.
The dispute concerns 2027 ratings and the effect those ratings may have on 2028 quality bonus payments. It does not, by itself, revise a plan’s 2027 premium, provider network, drug coverage or benefits.
What the 2027 Ratings Measure
CMS publishes Medicare Advantage and Part D Star Ratings each year. The ratings range from one to five stars and summarize plan performance across measures that include customer service, member experience, clinical outcomes and preventive care. CMS says the 2027 ratings were published on October 8 and appear on Medicare Plan Finder during open enrollment. The CMS 2027 Star Ratings fact sheet describes the methodology and measures.
Medicare Advantage contracts rated four stars or higher may qualify for quality bonus payments. Those payments affect plan funding and may support benefits or lower costs, but a rating does not guarantee that a particular benefit will be offered or that an individual’s costs will be lower. Eligible five-star plans also allow a one-time switch to a five-star plan during the calendar year under Medicare’s five-star special enrollment period.
Ratings are an official CMS quality signal. That is why a dispute about how they were calculated may matter to consumers even when they do not review the lawsuits. Still, a star score is only one part of a plan comparison.
What Star Ratings Do and Do Not Tell You
| A rating can summarize | A rating does not confirm |
|---|---|
| Performance on CMS quality measures, including member experience and clinical measures | Whether a specific doctor, hospital or pharmacy is in the 2027 network |
| An overall contract score and, where available, component scores | Whether a specific prescription is covered, its tier or whether prior authorization applies |
| A quality signal for comparing contracts | A person’s expected out-of-pocket costs or whether a plan fits their health needs |
Use the rating as one input, not as the decision itself. Check these plan details for the exact 2027 contract:
- Network: Confirm doctors, hospitals and pharmacies directly against the plan’s current network information.
- Total cost: Compare premiums, deductibles, copayments and the plan’s out-of-pocket maximum. The premium alone does not show total cost. Confirm the maximum in the plan’s Summary of Benefits and Coverage.
- Prescription drugs: Check each medication’s formulary tier, pharmacy requirements and any prior authorization or other restrictions.
- Relevant benefits: Review the dental, vision, transportation, virtual care or other benefits that matter to the household. Confirm the covered services and limits.
- Star rating: After checking the items above, use the overall rating as a cross-check. Review component scores where available, rather than relying only on the overall number.
Open Enrollment Timing and the December 7 Deadline
Medicare’s 2027 open enrollment period runs from October 15 through December 7, 2026. Changes made by December 7 generally take effect January 1, 2027. A lawsuit outcome will not change the ratings shown for current comparisons by the deadline; as of November 11, no court ruling has changed the published 2027 scores.
After December 7, most people enrolled in Medicare Advantage must wait until the Medicare Advantage Open Enrollment Period, January 1 through March 31, to make a permitted change. Eligibility and available options depend on individual circumstances.
Review the plan’s Annual Notice of Change alongside its 2027 plan documents. The Annual Notice of Change identifies adjustments to premiums, cost sharing, benefits and other plan terms. A pending lawsuit does not replace those documents. If CMS changes a rating later, any effect on a future year’s benefits or funding should be confirmed through official plan notices and updated CMS information. Rechecking coverage each fall remains relevant because ratings and plan terms can change from year to year.
Example: A Plan Drops From 4 to 3.5 Stars
Consider a 71-year-old whose Medicare Advantage plan is rated 3.5 stars for 2027 after showing four stars the prior year. The rating change alone does not establish that the plan is no longer suitable, and the lawsuits do not change her 2027 plan documents.
A practical review would include:
- Check the rating components. Determine which measures changed. Complaint or member-experience measures may have different significance to her than appeals handling or care-quality measures.
- Confirm her providers. Verify that her doctors, hospitals and pharmacies remain in network for the exact 2027 plan.
- Review her prescriptions and total cost. Check drug coverage and compare her expected costs with at least one alternative plan.
- Read the 2027 documents. Use the Annual Notice of Change and Summary of Benefits to confirm what is changing for the coming year.
A comparison based on providers, medications, benefits and total costs gives more specific information than the overall score alone. The litigation does not determine whether the plan will meet this person’s needs.
When an Agent Review May Be Useful
An insurance agent can review a plan’s rating components, compare plan networks and total costs, and explain what a rating change may mean for a particular household. Specific plan availability and agent credentials should be independently confirmed. Consumers looking for licensed Texas insurance agents can review Texas agent listings.
Summary
Medicare star ratings are being challenged by roughly 10 to 11 insurers, with the disputes focused on CMS’s calculation methods and potential 2028 quality bonus payments. The allegations remain unproven, and no court ruling has changed the 2027 ratings currently shown during open enrollment. For 2027 plan selection, the rating remains one quality signal alongside the plan’s network, total cost, prescription coverage and benefits. Available plan information should be checked independently before the December 7 deadline.