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STAT+: Judges skewer HHS arguments in hearing over Medicare Advantage audits lawsuit

2026-10-05 20:13
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STAT+: Judges skewer HHS arguments in hearing over Medicare Advantage audits lawsuit

Federal judges pushed back against the government's arguments in a Medicare Advantage case.

Federal appeals court judges didn’t take kindly to the Trump administration’s arguments Monday in a hearing on Humana’s lawsuit against the government over its rules for auditing Medicare Advantage plans. 

The country’s second largest Medicare Advantage insurer argued in its 2023 lawsuit, Humana v. Kennedy, that the Health and Human Services Department’s final rule for auditing Medicare Advantage plans diverged significantly from its proposed rule and that stakeholders weren’t given proper notice and opportunity to comment on the change, which they said would be detrimental to insurers. 

In September 2025, a federal judge agreed and invalidated the rule, called the risk adjustment data validation, or RADV, rule. HHS appealed in November. During Monday’s oral arguments, a three-judge panel of the U.S. Court of Appeals for the Fifth Circuit seemed poised to toss the rule out, again.

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Source: Tara Bannow · www.statnews.com