CMS withdraws notice of appeal over UnitedHealthcare's MA star ratings lawsuit

UPDATED: 2 p.m. on Jan. 24

The Centers for Medicare & Medicaid Services has changed course on plans to appeal a court ruling that determined it must recalculate UnitedHealthcare's Medicare Advantage star ratings.

The agency submitted a filing in Texas district court earlier this week saying it intended to file an appeal to the Fifth Circuit Court. In new court documents filed Friday, CMS has withdrawn its notice of appeal.

The filing doesn't include details on why CMS changed course so quickly. 

A Texas judge ruled in November that CMS would have to recalculate star ratings scores for UnitedHealthcare, the largest insurer in the MA market. The agency lost similar lawsuits brought by SCAN Health Plan and Elevance Health.


The feds intend to appeal a judge's decision that would force them to recalculate UnitedHealthcare's Medicare Advantage (MA) star ratings.

The Centers for Medicare & Medicaid Services (CMS) submitted a filing Tuesday in Texas district court saying that it would appeal the November ruling to the Fifth Circuit Court of Appeals. Further details were not included in the court filing.

Judge Jeremy Kernodle of Texas' East District Court ruled on Nov. 22 that the CMS would have to recalculate UnitedHealth's MA scores. 

At the center of the case is a single foreign language test phone call that was made to one of UnitedHealthcare's call centers. The CMS categorized the call as "unsuccessful" because it was disconnected before the test caller could fully engage with a customer service agent, according to UnitedHealth's lawsuit, which was filed in early October.

According to the suit, the call in question was the only unsuccessful foreign language call at that specific center. However, that single unsuccessful call prevented the center from earning five stars on this metric, and the four-star score led the overall star rating for multiple UnitedHealth plans to decrease by half a star.

The insurer argued that the call failed due to an error on the test caller's part and not the call center team.

The court also sided with UnitedHealth's argument that it raised concern about the call months earlier, but the CMS did not make any adjustments in response. The judge also said the agency should not have delegated these critical test calls to an outside contractor.

The ruling was the CMS' third loss in a lawsuit over the star ratings calculations, with SCAN Health Plan and Elevance Health also prevailing in court. It was also sued by Centene, Humana and others.