On Tuesday, U.S. District Judge Reed O’Connor in Fort Worth, Texas, upheld the government’s downgrade of Humana’s quality ratings for its Medicare Advantage plans — a decision that could cost the Louisville-based company billions in bonus payments. The judge ruled that the Centers for Medicare and Medicaid Services (CMS) “properly evaluated” Humana’s performance under federal standards, rejecting the company’s claims that the process was “arbitrary and capricious,” according to Reuters.