Biden administration to recalculate Medicare Advantage quality ratings and bonuses

The federal government is rescoring the quality ratings of this year’s Medicare Advantage plans, which could lead to an additional $1 billion of taxpayer money flowing into the coffers of health insurance companies.

Recent court decisions required the Biden administration to make these changes to insurers’ star ratings, many of which came in lower than companies had expected and cost them hundreds of millions of dollars in bonuses. While many companies will regain lost bonuses, no insurers will have to forfeit money from the new calculations, government officials said. The government also is reopening the process for Medicare Advantage insurers to submit their 2025 plans to account for these changes.

advertisement

The Wall Street Journal reported earlier about the government’s pending action. Top officials at the Centers for Medicare and Medicaid Services — the federal agency that oversees Medicare Advantage plans — formally laid out the plans in detail Thursday night in a memo that was sent to insurance companies.

STAT+ Exclusive Story

STAT+

This article is exclusive to STAT+ subscribers

Unlock this article — plus daily market-moving biopharma analysis — by subscribing to STAT+.

Already have an account? Log in

Already have an account? Log in

View All Plans

Get unlimited access to award-winning journalism and exclusive events.

Subscribe