RegulatoryJun 18, 2026, 04:12 PM
Clover Health's Medicare Advantage Star Ratings Increase to 4.5 Stars
AI Summary
Clover Health Investments, Corp. announced that the Centers for Medicare & Medicaid Services (CMS) recalculated its 2026 Star Ratings for two Medicare Advantage contracts. The PPO contract (H5141) rating increased from 3.5 to 4.5 Stars, and the HMO contract (H8010) rating increased from 4.0 to 4.5 Stars, both impacting payment year 2027. This recalculation by CMS for 2027 Quality Bonus Payment ratings followed a court judgment.
Key Highlights
- Clover Health's PPO Medicare Advantage contract (H5141) 2026 Star Rating increased from 3.5 to 4.5 Stars for payment year 2027.
- The company's HMO Medicare Advantage contract (H8010) 2026 Star Rating increased from 4.0 to 4.5 Stars, also impacting payment year 2027.
- CMS voluntarily recalculated 2027 Quality Bonus Payment ratings for certain Medicare Advantage contracts.
- The recalculation followed a court judgment in Clover Insurance Co. V. HHS.
Price Impact
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