SCAN Health Plan reply brief due today in $125M star ratings suit

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SCAN Health Plan reply brief due today in $125M star ratings suit

Plus: CMS restores $12B in Medicaid funding to Texas hospitals. The day's rules, money, and enforcement, sourced and tiered below.

Record

A health insurer's court deadline lands today in a fight over $125 million in Medicare quality bonus payments, part of a wider legal battle over how the government scores Medicare Advantage plans.

SCAN Health Plan's reply brief in its suit against CMS is due today. Elevance wants $115M and Alignment wants $50M in the same dispute over 2026 star ratings recalculations.

Record

The federal government just restored nearly $12 billion in Medicaid funding to Texas hospitals, ending a freeze that was the first of its kind since the program began in 2014.

CMS halted the money Sept 1 over a dispute about state provider taxes. Hospitals said they were losing $27 million a day before Gov. Abbott secured its return Sept 17.

Also today

CMS locks in mandatory ASM model for 5,556 specialists Read
DOJ reinstates Brand Memo, raises bar for guidance-based FCA suits Read
HRSA's 340B rebate pilot approval deadline lands in 2 days Read
GAO finds 26% of ACA plans cover abortion, flags disclosure gaps Read

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