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

Federal appeals court judges on Monday sharply questioned the Trump administration's arguments in a hearing on Humana's lawsuit over the government's rules for auditing Medicare Advantage plans. Humana, the country's second-largest Medicare Advantage insurer, brought the 2023 case, Humana v. Kennedy, arguing that HHS's final rule for auditing Medicare Advantage plans diverged significantly from its proposed rule and that stakeholders were not given proper notice and opportunity to comment on the change, which insurers said would be detrimental to them.

In September 2025, a federal judge agreed with Humana and invalidated the rule, known as 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, suggesting the appeals court may uphold the lower court's invalidation of the RADV rule.