Summary and Analysis – Clover Insurance Co. v. HHS

A federal district court in Georgia issued a sweeping ruling that could potentially undermine the legal foundation of the Medicare Advantage (MA) Star Ratings program and invite additional challenges to policies established through sub-regulatory guidance. The court found that the Centers for Medicare and Medicaid Services (CMS) improperly relied on measures based on data not collected through the statutorily required measurement systems and failed to meet notice-and-comment requirements for certain measures. 

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