Why are some 2027 Medicare Advantage quality-bonus ratings being recalculated?
Some 2027 quality-bonus ratings were recalculated because a federal court held that CMS exceeded its statutory authority in calculating ten star measures in the Clover case. CMS first recalculated Clover’s 2026 rating to 4.5 stars, then said it would voluntarily recalculate certain 2027 Quality Bonus Payment ratings as a result of that decision. CMS appealed, while Elevance separately challenged the recalculation and was denied a preliminary injunction. CMS released the official 2027 Medicare Advantage and Part D star ratings on October 8.
Trace the chain
The ratings dispute
- 1Star-rating rule changesRegulatory
2027 final rule reshapes star ratings and rolls back 2023 marketing safeguards
The contract-year 2027 rule dropped the planned health-equity reward in favour of the historical reward factor, removed a set of star measures including call-center tests and added a depression screening measure, codified the Inflation Reduction Act's Part D redesign, and eased marketing rules such as the 48-hour scope-of-appointment wait, effective October 1, 2026. CMS declined to finalise several beneficiary-protection proposals from the Biden era.
Centers for Medicare & Medicaid Services ·
First, for the 2027 Star Ratings, CMS is not implementing the Excellent Health Outcomes for All reward (previously called the Health Equity Index reward) that was developed to incentivize improved performance for a…
Why it matters here. Against the revised 2027 star-ratings framework, the next entry records a court ruling that CMS exceeded its statutory authority in calculating ten measures.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 2Clover court rulingLegal
Clover wins a ruling that CMS exceeded its authority on ten star-ratings measures
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.
Groom Law Group ·
On May 27, 2026, a federal district court granted partial summary judgment for Clover Insurance Company (“Clover”), holding that CMS exceeded its statutory authority in calculating ten Star Ratings measures and…
Why it matters here. The finding that CMS exceeded its authority on ten star measures led directly to reconsideration of ratings affected by those measures.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 3Clover rating resetRegulatory
CMS recalculates Clover rating to 4.5 stars
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.
Clover Health Form 8-K ·
On June 9, 2026, CMS informed Clover that, consistent with the Court’s order, it has recalculated Clover's 2026 Star Rating as 4.5 Stars, and has instructed Clover to submit alternate bids at 4.5 Stars.
Why it matters here. CMS's recalculation of Clover to 4.5 stars showed a contract-level consequence of the ruling, so it then issued guidance for certain 2027 quality-bonus ratings.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 42027 bonus recalculationRegulatory
CMS begins recalculating certain 2027 quality bonus ratings
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.
Clover Health Form 8-K ·
On June 17, 2026, CMS issued updated guidance informing all Medicare Advantage Organizations that it was voluntarily recalculating the 2027 Quality Bonus Payment ratings for certain Medicare Advantage contracts as a…
Why it matters here. CMS said its voluntary recalculation of certain 2027 Quality Bonus Payment ratings followed the Clover decision, and CMS then appealed that underlying decision.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 6Elevance challenges recalculationLegal
Elevance Health sues HHS and CMS over star-ratings recalculation
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.
U.S. District Court for the Southern District of Georgia order, reproduced by Justia ·
Plaintiffs filed the instant action on July 1, 2026.
Why it matters here. Elevance's lawsuit over the post-Clover recalculation sought preliminary court relief, leading to a decision on its injunction request.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 8Second ratings previewRegulatory
CMS opens second preview for preliminary 2027 star ratings
CMS made its second plan preview available from September 9 through September 15, 2026. The preview process includes draft cut points before official Medicare Advantage ratings are released.
CMS memorandum via DocumentCloud ·
“The second plan preview will be available starting September 9, 2026 and will end on September 15, 2026 at 11:59 p.m. Pacific time.”
Why it matters here. Rather than producing final ratings immediately, CMS's September 9–15 second preview kept the 2027 ratings preliminary ahead of official results expected in early October.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 9Official ratings releasedRegulatory
CMS releases 2027 Medicare Advantage and Part D star ratings
CMS released its 2027 Star Ratings for Medicare Advantage and Medicare Part D plans. CMS said 188 MA-PD contracts, approximately 37% of those offered in 2027, earned four stars or higher.
CMS ·
Approximately 37% of MA-PDs (188 contracts) that will be offered in 2027 earned four stars or higher for their 2027 overall rating.
Why it matters here. CMS’s release concluded the preliminary 2027 ratings-review phase that followed its recalculation guidance.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
What pushes back
- 5CMS appeals ruling
CMS files notice appealing Clover star-ratings ruling
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.
Clover Health Form 10-Q ·
On July 21, 2026, CMS filed its Notice of Appeal of the district court's decision in the Stars Litigation with the United States Court of Appeals for the Eleventh Circuit.
What it pushes against. CMS's appeal pushed against the district court's conclusion on the ten measures while the recalculations proceeded.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- 7Injunction denied
Federal judge denies Elevance star-ratings preliminary injunction
The U.S. District Court for the Southern District of Georgia denied Elevance Health's motion for a preliminary injunction over its Medicare Advantage star ratings. The court also denied the government's motion to dismiss the case.
U.S. District Court for the Southern District of Georgia order, reproduced by Justia ·
ORDER denying #34 Motion to Dismiss; denying #7 Motion for Preliminary Injunction.
What it pushes against. The denial left CMS's recalculation in place during the preliminary stage, so plans continued through CMS's 2027 ratings-review process.
Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
Changes to this chain
- Proposal #215 accepted (publish:medicare-advantage-2027): insert after 8: [cause] Official ratings released -> medicare-advantage-2027#2134: CMS’s release concluded the preliminary 2027 ratings-review phase that followed its recalculation guidance.; answer: Some 2027 quality-bonus ratings were recalculated because a federal court held that CMS exceeded its statutory authority in calculating ten star measures in the Clover case. CMS first recalculated Clover’s 2026 rating to 4.5 stars, then said it would voluntarily recalculate certain 2027 Quality Bonus Payment ratings as a result of that decision. CMS appealed, while Elevance separately challenged the recalculation and was denied a preliminary injunction. CMS released the official 2027 Medicare Advantage and Part D star ratings on October 8.
- Proposal #142 accepted (verify:v2): why of step 4 -> CMS said its voluntary recalculation of certain 2027 Quality Bonus Payment ratings followed the Clover decision, and CMS then appealed that underlying decision.
- Proposal #42 accepted (verify:v1): why of step 1 -> Against the revised 2027 star-ratings framework, the next entry records a court ruling that CMS exceeded its statutory authority in calculating ten measures.; why of step 8 -> Rather than producing final ratings immediately, CMS's September 9–15 second preview kept the 2027 ratings preliminary ahead of official results expected in early October.
Timelines in this chain
- Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment
- Social Security's Next Raise: From the 2.5% COLA to the 2027 Announcement
A chain is written by the editor from entries already published on the timelines above, each of which was read against its source before publication. The chain changes when those entries do. Data and terms.