A federal judge in Fort Worth, Texas, dismissed Elevance Health’s lawsuit challenging how the Centers for Medicare & Medicaid Services calculated the insurer’s 2025 Medicare Advantage star ratings. U.S. District Judge Mark T. Pittman ruled that the agency’s rounding methodology complied with federal regulations and described Elevance’s mathematical arguments as “perplexing.” Elevance, whose brands include Anthem Blue Cross and Blue Shield, argued that CMS should have rounded its contract score of 3.749565 up to 4.0 stars instead of down to 3.5 stars. The company said the half-star difference could cost it at least $375 million in bonus and other payments tied to higher-rated plans. The court found no significant flaws in the government’s calculations and said reviewing the complex rating model further was beyond the court’s remit. The decision marks the second recent setback for Medicare Advantage insurers trying to reverse lower 2025 star scores; a separate Texas judge last month tossed a similar suit brought by Humana on procedural grounds. CMS has faced a flurry of legal challenges after an industry-wide drop in ratings reduced expected incentive payments worth hundreds of millions of dollars.