MA STARS Act
- Sponsor
- Rep. Kelly, Mike [R-PA-16]
- Committees
- Ways and Means Committee (primary)
- Last action
- Sep 21, 2026
Bottom line
This bill aims to refine the Medicare Advantage Star Ratings system to focus on more relevant and reliable quality measures, enhance transparency, and promote fair competition among MA plans.
What it actually does
H.R. 10521, the MA STARS Act, directs the Secretary of Health and Human Services to revise the regulations governing the Medicare Advantage (MA) 5-star rating system starting with the 2031 contract year. It mandates the exclusion of certain measures not related to clinical quality or patient experience, those not attributable to the plan's actions, or those based on flawed survey data. The bill also requires the establishment of two technical expert panels to recommend improvements to beneficiary surveys and the overall rating methodology, and mandates annual public reporting on the rating distribution and methodology.
Proponents argue
Proponents argue that the current MA Star Ratings system includes measures that do not accurately reflect plan performance, are not within the plan's direct control, or are based on unreliable survey data, leading to an unfair assessment of quality. They contend that this bill will ensure the rating system is more precise, transparent, and focused on meaningful clinical outcomes and patient experience, thereby better serving beneficiaries and encouraging plans to improve in areas that truly matter.
Opponents contend
Critics might argue that revising the Star Ratings system could inadvertently remove important accountability metrics, potentially making it harder for beneficiaries to compare plans effectively. They might also express concern that the proposed changes could be influenced by industry interests, leading to a system that is less rigorous or less comprehensive in evaluating MA plan performance, or that the criteria for exclusion are too broad and could be exploited.
The bill is concise and can be read and understood quickly, allowing ample time for stakeholders to evaluate its proposed changes to the MA Star Ratings system.
Section 2(a)(1)
Revision of MA Star Ratings Measure Inclusion Criteria
This provision directs the Secretary of HHS to update the rules for the Medicare Advantage 5-star rating system. Specifically, it requires the exclusion of measures that don't directly relate to a patient's clinical quality, health outcomes, or experience. It also excludes measures that plans can't reasonably control, or those based on surveys that are too long, lack diverse responses, or don't meet minimum data quality standards. Additionally, measures that no longer help differentiate performance among plans would be excluded from the main rating calculation.
Supporters argue
Supporters argue this change will make the Star Ratings system more accurate and fair by removing irrelevant or unreliable measures, allowing MA plans to focus on improving areas truly within their control and directly impacting patient care. This will lead to more meaningful competition and better outcomes for beneficiaries.
Critics contend
Critics might contend that removing measures, even if deemed "less relevant," could reduce the comprehensiveness of the rating system, potentially masking areas where plans could still improve. They might also worry about the subjective nature of determining what is "reasonably attributable" to an issuer's actions.
Tradeoffs
The tension lies between simplifying the rating system for clarity and maintaining a comprehensive set of metrics for robust accountability. There's also a balance between giving plans control over their scores and ensuring they are held responsible for a broad range of factors impacting beneficiaries.
Section 2(a)(2)
Inclusion of New Measures Based on Clinical Quality, Patient Outcomes, or Patient Experience
This part of the bill specifies that any new measures introduced into the Star Ratings program for the 2031 contract year and beyond must directly relate to clinical quality, patient outcomes, or patient experience. This ensures that future additions to the rating system remain focused on core aspects of healthcare delivery and beneficiary well-being.
Section 2(a)(3)
Display-Only Reporting for Non-Competitive Measures
For measures that are excluded from the main Star Ratings calculation because they are no longer competitive (meaning most plans perform well on them, so they don't help differentiate performance), this provision requires them to still be publicly reported as "display-only" measures. This means the data will still be available for public viewing, but it won't count towards a plan's overall star rating.
Section 2(b)
Beneficiary Survey Technical Expert Panel
This section mandates the creation of a technical expert panel (TEP) to review and recommend better ways to use beneficiary surveys in the Star Ratings program. The panel will look for surveys that are statistically sound, developed by reputable organizations, relevant to patient experience, and designed to get diverse and representative responses. The goal is to improve the reliability and fairness of survey-based measures. The panel must submit a report with recommendations within two years.
Section 2(c)
Star Ratings Methodology Technical Expert Panel
This section requires the creation of another technical expert panel (TEP) to evaluate the way Star Ratings are calculated, specifically how measure-level cut points are set and how overall Star Ratings are assigned. The panel's goal is to recommend reforms that better reward high performance and promote competition among MA plans. This panel also has two years to submit its report after soliciting stakeholder feedback.
Section 2(d)
Annual Public Report on Star Ratings Distribution and Methodology
Starting with the 2031 contract year, the Secretary of HHS must annually publish a report detailing the distribution of overall Star Ratings and explaining the methodology used to set cut points and assign ratings for that year. This report must also list any measures that were excluded from the Star Ratings calculation, along with the specific reason for their exclusion and the rationale behind that decision.