Clover Health
Role in each timeline
- Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
Won a district-court ruling against aspects of CMS's star methodology, obtained a recalculated rating, and is defending that ruling on appeal.
Clover Health across every timeline
Every dated entry that names Clover Health, from all 1 timeline, newest first.
- Clover Health says its PPO MA plans earned five stars for 2027 Announcement
Clover Health said CMS awarded its PPO Medicare Advantage plans five stars and its HMO plan 4.5 stars for 2027. Clover Health said the ratings would affect payment year 2028.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment - CMS files notice appealing Clover star-ratings ruling Legal
CMS filed a notice of appeal to the U.S. Court of Appeals for the Eleventh Circuit against the May ruling that it had exceeded its authority on ten star-ratings measures, according to Clover's 10-Q and a Becker's report citing a July 21 court filing; the appellate docket shows the case opened July 22. CMS had meanwhile recalculated Clover's rating to 4.5 stars and begun recalculating other 2027 quality-bonus ratings.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment - Elevance Health sues HHS and CMS over star-ratings recalculation Legal
Elevance Health sued the Department of Health and Human Services and the Centers for Medicare & Medicaid Services over the recalculation of Medicare Advantage quality ratings. Elevance Health alleged that the recalculation did not align with the Clover Health ruling and affected $115 million in payments.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment - CMS begins recalculating certain 2027 quality bonus ratings Regulatory
CMS issued guidance that it was voluntarily recalculating 2027 Quality Bonus Payment ratings for certain Medicare Advantage contracts. CMS said the recalculation resulted from the preceding court decision.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment - CMS recalculates Clover rating to 4.5 stars Regulatory
CMS informed Clover that it had recalculated Clover's 2026 Star Rating to 4.5 stars. CMS instructed Clover to submit alternate bids using the 4.5-star rating.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment - Clover wins a ruling that CMS exceeded its authority on ten star-ratings measures Legal
A federal district court granted Clover Insurance partial summary judgment, holding that CMS exceeded its statutory authority in calculating ten star measures and skipped notice-and-comment on ten more, the second court in a year to upend the ratings. Humana cited the decision in its pending Fifth Circuit appeal a week later.
on Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment