Clover Health wins court case, gets Medicare star rating raised to 4.5
Clover Health Investments (NASDAQ: CLOV) received a 4.5 star rating from the Centers for Medicare & Medicaid Services following a successful court challenge, the company announced.
The U.S. District Court for the Southern District of Georgia granted summary judgment in favor of Clover Insurance Company, a subsidiary of Clover Health, on May 29. The court set aside Clover's original 2026 star rating of 3.5 stars for Contract H5141 and ordered CMS to recalculate the rating.
On June 9, CMS informed Clover that it recalculated the 2026 star rating as 4.5 stars for Contract H5141, which covers more than 97% of Clover's members. The rating affects Payment Year 2027.
The upgraded rating applies to Clover's PPO plan under Contract H5141. The company's HMO plan under Contract H8010 was not subject to the litigation and maintains its 2026 star rating of 4.0 stars.
CMS has instructed Clover to submit alternate bids based on the 4.5 star rating, according to the company's statement based on a press release.
