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A Texas judge dismissed Humana’s lawsuit, upholding a CMS decision to downgrade its Medicare Advantage rating due to failed interpreter tests, potentially costing the company $1 billion.
A Texas federal judge has dismissed Humana’s lawsuit challenging the government’s 2025 Medicare Advantage star ratings, upholding CMS’s decision to downgrade the insurer’s score due to failed language interpreter test calls.
The ruling, issued just before open enrollment, confirms CMS’s authority to prohibit insurers from calling back during evaluations and bars future legal challenges.
The downgrade could cost Humana up to $1 billion in bonus payments and reduce its 4-star or higher plan enrollment to 20%.
The decision reinforces federal control over Medicare Advantage reimbursements and may influence how insurers prepare for future ratings.
Un juez de Texas desestimó la demanda de Humana, confirmando una decisión de CMS de rebajar su calificación de Medicare Advantage debido a pruebas fallidas de intérprete, lo que podría costarle a la compañía $ 1 mil millones.