- Docket No.
- District Court
- Texas Northern
- Block government from enforcing payment recoveries against Humana under new audit methodology
- Declaration that Medicare Advantage audit regulation violates the Administrative Procedure Act
- Invalidate all or part of a regulation
Why this Matters:
The plaintiffs argue that a regulation concerning audits of coding practices under the Medicare Advantage program violates the Administrative Procedure Act. Implementing the new audit methodology could allow the federal government to recoup billions in associated overpayments with certain coding practices by Medicare Advantage plans.
The inability to curb improper overpayments in the Medicare Advantage program would prevent the federal government from ensuring that taxpayer funds are spent appropriately.