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UnitedHealth sues CMS over quality rating drop tied to phone call

By Bloomberg Law  
   October 04, 2024

Affiliates of one of the nation's largest Medicare Advantage plans sued the Biden administration claiming that their quality rating was unreasonably downgraded after one customer service phone call. The complaint filed this week by subsidiaries of insurance giant UnitedHealth Group Inc. alleges CMS downgraded the company's 'Star Ratings' based on an 'arbitrary and capricious assessment of how Plaintiffs' call center handled a single phone call that lasted less than ten minutes.' The plaintiffs asked the court to act urgently with an injunction to correct the CMS rating, as open enrollment is set to begin Oct. 15.

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