Centene Sues CMS Over Medicare Advantage Ratings; UnitedHealthcare Lawsuit Follows $7.5 Billion Oversight Call and $3.3 Billion Merger Talks

Centene Corporation has initiated legal action against the Centers for Medicare & Medicaid Services (CMS) following a downgrade in its Medicare Advantage ratings. Concurrently, UnitedHealthcare has filed a lawsuit against CMS, claiming that a phone call negatively impacted its Star ratings. These developments come amid scrutiny of private Medicare Advantage plans, as a government watchdog has called for increased oversight of these plans, which collectively received $7.5 billion in enhanced payments in 2023, potentially based on questionable patient diagnoses. In another significant move, UnitedHealth Group and Amedisys are reportedly in final negotiations with the Department of Justice (DOJ) to secure their $3.3 billion merger deal, with meetings scheduled for next week to address antitrust concerns regarding their proposed tie-up.