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Time of India
a day ago
- Health
- Time of India
Humana renews challenge to downgrade of US Medicare 'star' ratings
Humana on Monday filed a new lawsuit over the U.S. government's reduction in the health insurer's star ratings for government-backed Medicare plans, after an earlier challenge was dismissed on technical grounds. Humana, in the lawsuit in Fort Worth, Texas, federal court, says the lower ratings could cause it to lose customers and potentially billions of dollars in bonus payments from the government, which would have been used to reduce premiums and increase benefits for its members. U.S. District Judge Reed O'Connor in Fort Worth dismissed those claims last week, finding Humana had failed to exhaust all of its out-of-court options to challenge the ratings. In the new lawsuit, Humana says it has in recent months exhausted an administrative appeals process, giving the insurer standing to sue. "A final Star Rating determines legal rights and obligations, and legal consequences flow from them," the company said. The U.S. Department of Health and Human Services, which oversees Medicare, did not immediately respond to a request for comment. Humana is one of the largest providers of Medicare Advantage plans in the U.S., which are funded by the Medicare health insurance program for seniors and some disabled people but administered by private insurers. The U.S. Centers for Medicare and Medicaid Services, which is part of HHS, issues star ratings for the plans, from one to five stars, to help beneficiaries choose. Plans with higher star ratings receive higher payments from the government if they keep costs below certain targets. Those bonus payments can be worth hundreds of millions or billions of dollars.
Mint
5 days ago
- Business
- Mint
Humana Falls After Losing Bid to Reverse Medicare Bonus Cuts
(Bloomberg) -- Humana Inc. shares fell after it lost a lawsuit seeking to reverse cuts to its Medicare bonus payments, a blow for the insurer that had hoped the court would restore billions in revenue. A Texas judge ruled in favor of a government motion to dismiss the case, allowing a downgrade of Humana's Medicare quality ratings that's set to squeeze the company's profits in 2026. Humana shares dropped as much as 7.5% before paring losses. The judge called Humana's federal court claim 'premature' because the company hadn't exhausted all the administrative procedures over the decision. The lawsuit was dismissed 'without prejudice,' which means Humana could file the court case again. 'Plaintiffs can seek review, just not until the end of the administrative appeal process,' the judge wrote. In April, the insurer lost an administrative appeal with the Centers for Medicare and Medicare Services. In a court filing that month, the company argued that the administrative decision should invalidate one of the government's arguments for dismissing the suit. US District Court Judge Reed O'Connor disagreed. While he acknowledged the administrative appeal was over, he wrote that 'when filed, this action was premature,' and the court could not rule on the merits. That decision could pave the way for the company to quickly challenge the ratings in a fresh lawsuit. Humana will explore its legal options, including 'either an appeal of today's order or a refiling of the lawsuit,' a spokesperson said in an email. CMS didn't immediately respond to a request for comment. Other insurer stocks fell Friday, with Elevance Health Inc. declining as much as 7.6%. Molina Healthcare Inc. shares fell as much as 5.6%. They'd already been under pressure due to challenges in government insurance programs from Medicare to Medicaid and the Affordable Care Act markets. The decision is a defeat for the insurance giant in a high-stakes legal gambit to challenge unfavorable results on its Medicare quality scores. A win would have almost doubled Humana's 2026 profit, Barclays analysts wrote in April, to $27.74 a share. Humana filed the lawsuit in October to challenge how the US Medicare program calculated the quality ratings, known as stars, for Humana's plans. The company suffered a surprise downgrade in its star ratings in October that sent shares plunging. The ratings are meant to reflect how well Medicare health plans take care of patients and how they perform on customer service, like handling complaints and service calls. High star ratings drive billions of dollars in Medicare bonus payments to private insurers. The program paid $11.8 billion in bonuses in 2024, including $2.5 billion to Humana, according to health research group KFF. More than any large health insurer, Louisville, Kentucky-based Humana is focused on Medicare Advantage, the private version of the US health program for seniors. Profit in that business is heavily linked to performing well on annual quality ratings. The company previously had about 94% of members in highly rated plans that pay bonuses, but that slipped to about 25% in the most recent assessment. In its October lawsuit, Humana argued that the Centers for Medicare and Medicaid Services erred in how it calculated the company's star ratings, and asked the court to throw out the negative scores. --With assistance from Steve Stroth. (Adds company comment in sixth paragraph.) More stories like this are available on
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Business Standard
19-06-2025
- Business
- Business Standard
Families of 737 crash victims urge US judge to reject Boeing deal
Lawyers for 15 families argued Boeing should stand trial for criminal conspiracy as the government had originally planned, to hold the company more accountable for the deaths of 346 people Bloomberg Family members of people killed in two fatal crashes of Boeing Co's 737 Max jets urged a federal judge to reject a proposed deal the company reached with US prosecutors that would allow the planemaker to avoid a criminal charge. Lawyers for 15 families argued Boeing should stand trial for criminal conspiracy as the government had originally planned, to hold the company more accountable for the deaths of 346 people, according to a court filing Wednesday. Some family members asked the judge to appoint a special prosecutor to oversee the case. 'The conspiracy charge against Boeing has been pending now for more than four years,' the families' lawyers said. 'Boeing has admitted all the facts necessary to prove it is guilty. And yet, the government now moves to dismiss the charge.' They added, 'It is difficult to imagine a case more deserving of a public trial than this one.' The US Justice Department in May asked US District Judge Reed O'Connor in Fort Worth to dismiss the case as part of a proposed settlement reached with Boeing. Under the deal, the planemaker agreed to pay more than $1.1 billion in fees and fines, while taking steps to strengthen internal quality and safety measures. In return, the company will avoid criminal prosecution. Prosecutors have argued that the deal 'secures meaningful accountability' and ensures Boeing faces penalties and oversight, an outcome they say would not be guaranteed if they took the case to trial. Asked to comment on the relatives' objections, a Boeing representative pointed to a May 29 company statement. 'Boeing is committed to complying with its obligations under this resolution, which include a substantial additional fine and commitments to further institutional improvements and investments,' the company said. The families also claimed language in the deal would obligate the government to not prosecute Boeing even if O'Connor rejects the motion to dismiss the case, which would skirt full judicial review. 'If this court approves the parties' maneuver in this widely publicized case, then this unprecedented approach will likely become the blueprint for all future dismissal motions in federal criminal prosecutions,' they said in the filing. In a separate filing, some family members asked the judge to appoint an independent prosecutor to 'restore integrity to these proceedings and ensure that justice — rather than politics — guides the resolution of this matter.' Relatives of crash victims have spent years fighting for harsher penalties for Boeing following the two fatal crashes of its 737 Max jet in 2018 and 2019. Both crashes were linked to a flawed flight control system on the jets. The families said the fatal Air India crash earlier this month involving a Boeing 787 Dreamliner shows that 'the stakes for aviation safety are very high.' The cause of the crash remains under investigation. To be sure, some families support the settlement. But those who want Boeing to go to trial said the company had dangled money 'in front of the families, apparently hoping that it will lead them to back off their efforts to hold Boeing accountable for killing their loved ones. And Boeing's offer appears to have had the desired effect, at least with respect to a few families.' If O'Connor agrees to a dismissal, it would end the long-running criminal case against Boeing over the crashes. But it would also mark a notable reversal in the proceedings. Just last year, Boeing had agreed to plead guilty to the pending criminal conspiracy charge under a deal that was ultimately rejected by O'Connor. Under the new settlement Boeing will admit to the underlying accusation of 'conspiracy to obstruct and impede the lawful operation of the Federal Aviation Administration Aircraft Evaluation Group,' but that admission does not constitute a guilty plea. The government said it could refile criminal charges against the company if Boeing is accused of violating the terms of the two-agreement. Some family members dispute that claim, saying the statute of limitations has already expired. The agreement requires Boeing to pay a total of $1.1 billion in assorted fines and fees. The total includes: $487.2 million for a criminal penalty, half of which the company already paid to the government during an earlier phase of the case $444.5 million for a new 'Crash-Victims Beneficiaries Fund' that will be divided evenly by crash victim $455 million in investments to bolster its compliance, safety and quality programs Boeing would be required to retain a so-called independent compliance consultant to oversee its efforts to improve the effectiveness of its anti-fraud compliance and ethics program. The consultant will be expected to make recommendations for improvements and report their findings directly to the government. The case is US v. Boeing, 21-cr-005, US District Court, Northern District of Texas (Fort Worth).
Straits Times
19-06-2025
- Business
- Straits Times
Families of 737 crash victims urge rejection of Boeing deal
NEW YORK – Family members of people killed in two fatal crashes of Boeing's 737 Max jets urged a federal judge to reject a proposed deal the company reached with US prosecutors that would allow the planemaker to avoid a criminal charge. Lawyers for 15 families argued Boeing should stand trial for criminal conspiracy as the government had originally planned, to hold the company more accountable for the deaths of 346 people, according to a court filing on June 18. Some family members asked the judge to appoint a special prosecutor to oversee the case. 'The conspiracy charge against Boeing has been pending now for more than four years,' the families' lawyers said. 'Boeing has admitted all the facts necessary to prove it is guilty. And yet, the government now moves to dismiss the charge.' They added, 'It is difficult to imagine a case more deserving of a public trial than this one.' The US Justice Department in May asked US District Judge Reed O'Connor in Fort Worth to dismiss the case as part of a proposed settlement reached with Boeing. Under the deal, the planemaker agreed to pay more than US$1.1 billion (S$1.41 billion) in fees and fines, while taking steps to strengthen internal quality and safety measures. In return, the company will avoid criminal prosecution. Prosecutors have argued that the deal 'secures meaningful accountability' and ensures Boeing faces penalties and oversight, an outcome they say would not be guaranteed if they took the case to trial. Asked to comment on the relatives' objections, a Boeing representative pointed to a May 29 company statement. 'Boeing is committed to complying with its obligations under this resolution, which include a substantial additional fine and commitments to further institutional improvements and investments,' the company said. In June 18's filing, lawyers for family members who oppose the agreement said it would essentially allow the company to 'buy its way out of a criminal conviction'. The families also claimed language in the deal would obligate the government to not prosecute Boeing even if Mr O'Connor rejects the motion to dismiss the case, which would skirt full judicial review. 'If this court approves the parties' maneuver in this widely publicised case, then this unprecedented approach will likely become the blueprint for all future dismissal motions in federal criminal prosecutions,' they said in the filing. In a separate filing, some family members asked the judge to appoint an independent prosecutor to 'restore integrity to these proceedings and ensure that justice – rather than politics – guides the resolution of this matter.' Relatives of crash victims have spent years fighting for harsher penalties for Boeing following the two fatal crashes of its 737 Max jet in 2018 and 2019. Both crashes were linked to a flawed flight control system on the jets. The families said the fatal Air India crash earlier this month involving a Boeing 787 Dreamliner shows that 'the stakes for aviation safety are very high'. The cause of the crash remains under investigation. To be sure, some families support the settlement. But those who want Boeing to go to trial said the company had dangled money 'in front of the families, apparently hoping that it will lead them to back off their efforts to hold Boeing accountable for killing their loved ones. And Boeing's offer appears to have had the desired effect, at least with respect to a few families'. If Mr O'Connor agrees to a dismissal, it would end the long-running criminal case against Boeing over the crashes. But it would also mark a notable reversal in the proceedings. Just in 2024, Boeing had agreed to plead guilty to the pending criminal conspiracy charge under a deal that was ultimately rejected by Mr O'Connor. Under the new settlement Boeing will admit to the underlying accusation of 'conspiracy to obstruct and impede the lawful operation of the Federal Aviation Administration Aircraft Evaluation Group,' but that admission does not constitute a guilty plea. The government said it could refile criminal charges against the company if Boeing is accused of violating the terms of the two-agreement. Some family members dispute that claim, saying the statute of limitations has already expired. The agreement requires Boeing to pay a total of US$1.1 billion in assorted fines and fees. The total includes: US$487.2 million for a criminal penalty, half of which the company already paid to the government during an earlier phase of the case US$444.5 million for a new 'crash-victims beneficiaries fund' that will be divided evenly by crash victim US$455 million in investments to bolster its compliance, safety and quality programs Boeing would be required to retain a so-called independent compliance consultant to oversee its efforts to improve the effectiveness of its anti-fraud compliance and ethics program. The consultant will be expected to make recommendations for improvements and report their findings directly to the government. BLOOMBERG Join ST's Telegram channel and get the latest breaking news delivered to you.
Mint
18-06-2025
- Business
- Mint
Families of 737 Crash Victims Urge Rejection of Boeing Deal
(Bloomberg) -- Family members of people killed in two fatal crashes of Boeing Co.'s 737 Max jets urged a federal judge to reject a proposed deal the company reached with US prosecutors that would allow the planemaker to avoid a criminal charge. Lawyers for 15 families argued Boeing should stand trial for criminal conspiracy as the government had originally planned, to hold the company more accountable for the deaths of 346 people, according to a court filing Wednesday. 'The conspiracy charge against Boeing has been pending now for more than four years,' the families' lawyers said. 'Boeing has admitted all the facts necessary to prove it is guilty. And yet, the government now moves to dismiss the charge.' They added, 'It is difficult to imagine a case more deserving of a public trial than this one.' The US Justice Department in May asked US District Judge Reed O'Connor in Fort Worth to dismiss the case as part of a proposed settlement reached with Boeing. Under the deal, the planemaker agreed to pay more than $1.1 billion in fees and fines, while taking steps to strengthen internal quality and safety measures. In return, the company will avoid criminal prosecution. Prosecutors have argued that the deal 'secures meaningful accountability' and ensures Boeing faces penalties and oversight, an outcome they say would not be guaranteed if they took the case to trial. A representative of Boeing didn't immediately respond to a request for comment. In Wednesday's filing, lawyers for family members who oppose the agreement said it would essentially allow the company to 'buy its way out of a criminal conviction.' The families also claimed language in the deal would obligate the government to not prosecute Boeing even if O'Connor rejects the motion to dismiss the case, which would skirt full judicial review. 'If this court approves the parties' maneuver in this widely publicized case, then this unprecedented approach will likely become the blueprint for all future dismissal motions in federal criminal prosecutions,' they said in the filing. Relatives of crash victims have spent years fighting for harsher penalties for Boeing following the two fatal crashes of its 737 Max jet in 2018 and 2019. Both crashes were linked to a flawed flight control system on the jets. The families said the fatal Air India crash earlier this month involving a Boeing 787 Dreamliner shows that 'the stakes for aviation safety are very high.' The cause of the crash remains under investigation. To be sure, some families support the settlement. But those who want Boeing to go to trial said the company had dangled money 'in front of the families, apparently hoping that it will lead them to back off their efforts to hold Boeing accountable for killing their loved ones. And Boeing's offer appears to have had the desired effect, at least with respect to a few families.' If O'Connor agrees to a dismissal, it would end the long-running criminal case against Boeing over the crashes. But it would also mark a notable reversal in the proceedings. Just last year, Boeing had agreed to plead guilty to the pending criminal conspiracy charge under a deal that was ultimately rejected by O'Connor. Under the new settlement Boeing will admit to the underlying accusation of 'conspiracy to obstruct and impede the lawful operation of the Federal Aviation Administration Aircraft Evaluation Group,' but that admission does not constitute a guilty plea. The government said it could refile criminal charges against the company if Boeing is accused of violating the terms of the two-agreement. Some family members dispute that claim, saying the statute of limitations has already expired. The agreement requires Boeing to pay a total of $1.1 billion in assorted fines and fees. The total includes: Boeing would be required to retain a so-called independent compliance consultant to oversee its efforts to improve the effectiveness of its anti-fraud compliance and ethics program. The consultant will be expected to make recommendations for improvements and report their findings directly to the government. The case is US v. Boeing, 21-cr-005, US District Court, Northern District of Texas (Fort Worth). --With assistance from Allyson Versprille. (Updates with outreach to Boeing for comment.) More stories like this are available on
