The MA STARS Act would require the Secretary of Health and Human Services to revise Medicare Advantage’s 5-star rating rules for the 2031 contract year and later years. The rules would exclude certain measures, including measures the Secretary finds unrelated to clinical quality, patient outcomes, or patient experience, or not reasonably tied to actions by the insurer or its delegated entities. Some survey-based measures would also be excluded if surveys are too long or do not meet standards for diverse and representative responses. Measures that no longer distinguish among most contracts would be reported publicly as display-only measures.
The bill would create two expert panels. One would recommend reliable beneficiary surveys; the other would review how measure cut points and overall ratings are calculated. Both panels would seek stakeholder feedback and report to the Secretary within two years of enactment. Starting with the 2031 contract year, the Secretary would also publish annual reports on rating distributions, methods, and excluded measures, including reasons for exclusion.
People enrolled in Medicare Advantage could see changes in which measures count toward a plan’s star rating. The bill would also require public reporting about rating methods and excluded measures. The bill does not specify how an individual plan’s rating would change.
The bill does not specify costs or funding.
No publicly available information.
No publicly available information.