Clover’s Star Ratings win puts CMS’s authority over MA quality measures in question

Medicare Advantage has faced mounting pressure over the past two years, with bipartisan scrutiny of high costs, upcoding, prior authorization and roughly 40 health systems dropping plans in 2025 over denials and slow payments. Against that backdrop, a federal judge's ruling for Clover Health—ordering CMS to recalculate the insurer's 3.5-star rating—is a rare decision that runs the insurers' way. If the decision survives appeal, it could force a broader rework of how MA plans are scored.