Alignment Healthcare Inc. v. HHS: Date Argued: February 2nd, 2026; Docket Number: 25-5239
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Alignment Healthcare Inc. v. HHS: Date Argued: February 2nd, 2026; Docket Number: 25-5239
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概要
Case Summary:
In Alignment Healthcare Inc. v. HHS (Docket No. 25-5239), argued before the D.C. Circuit on February 2, 2026, Alignment Healthcare challenged the methodology used by CMS to determine Medicare Advantage "Star Ratings."
The crux of the dispute centers on the Tukey Outlier Rule, which Alignment argues is an arbitrary statistical method that unfairly lowers quality scores by deleting valid data points, thereby depriving insurers of significant federal bonus payments. While the District Court previously granted a partial win regarding a specific Arizona plan's rating, it upheld the broader use of the Tukey rule.
During the appellate oral arguments, the panel focused on whether CMS violated the Administrative Procedure Act and if the agency failed to account for language barriers in patient surveys. A reversal could trigger a massive recalculation of ratings and bonus payments across the entire Medicare Advantage industry.