Welcome back to The Healthcare STARcast with host Subbu Ramalingam. In today’s episode, we dive deep into the waves shaking up the Medicare Advantage world, especially the storm surrounding the Star Ratings system. Just weeks after the July 4th holiday, headline-grabbing lawsuits and court decisions have placed CMS and health plans in the legal crosshairs, forcing rule recalculations and questioning the very framework of quality ratings.
We’re joined by Mark Newsom, former CMS executive and now an industry consultant, who brings a front-row perspective to the chaos. Mark unpacks the litigation saga, from high-profile court victories and defeats to the broader impact of the recent Loper Bright Supreme Court ruling that’s fueling even more challenges against federal health agencies. We’ll break down what’s at stake for payers, providers, and beneficiaries, and hear Mark’s take on how Star Ratings and Medicare Advantage itself could be transformed in the years ahead.
With so much in flux, this is a defining leadership moment for industry professionals operating at every level. Whether you’re managing member experience, responsible for board communications, or strategizing on compliance and risk, Mark has practical advice for how operators and leaders can navigate this period of uncertainty. Stay tuned as we untangle the latest and look towards what’s next for the future of MA Star Ratings.
Timestamps:
00:00 Discussing star rating lawsuits
05:10 Background on the Loper Bright Case
06:27 Challenges in administrative law cases
11:25 CMS oversight and audit measures
12:52 Medicare Advantage guidance challenges
17:38 Discussing Medicare Part D criticism
19:35 Clover litigation and broader implications
23:19 Understanding survey response issues
28:50 Lobbying CMS for higher ratings
31:17 CMS as a perceived mystery
36:04 Focusing on quality over metrics
38:16 Discussing litigation planning steps
42:20 Discussing Changes in Medicare Advantage
43:46 Wrap-up and future discussions
Show Website - https://healthcarestarcast.com/
Subbu Ramalingam - Show Host - Linkedin - https://www.linkedin.com/in/subburamalingam/
FloWise Leadership - https://flowiseleadership.com/
ViVega Business Services - https://www.vivega.co/
ATTAC Consulting Group - https://www.attacconsulting.com/
Media Partner - TopHealth - https://tophealth.care/
“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”
