{"id":11449,"date":"2018-09-11T11:17:18","date_gmt":"2018-09-11T15:17:18","guid":{"rendered":"https:\/\/medicarereport.org\/?p=11449"},"modified":"2018-09-11T11:17:18","modified_gmt":"2018-09-11T15:17:18","slug":"judge-throws-out-cms-2014-rule-now-how-will-cms-determine-whether-it-has-overpaid","status":"publish","type":"post","link":"https:\/\/medicarereport.org\/?p=11449","title":{"rendered":"Judge throws out CMS 2014 rule, now how will CMS determine whether it has overpaid"},"content":{"rendered":"<p>On Friday, the U.S. District Court for the District of Columbia granted UnitedHealth\u2019s motion for summary judgement and vacated CMS\u2019s 2014 overpayment rule. According to the ruling, one of the issues is that the current way CMS calculates payment results in a false appearance of better health among Medicare Advantage enrollees compared to traditional Medicare participants, leading to systematic underpayments to MA insurers. This leads to the question of how CMS will amend the rule determine whether it has overpaid a Medicare Advantage (MA) insurer. <a href=\"https:\/\/www.healthcarefinancenews.com\/news\/unitedhealthcare-wins-court-case-over-medicare-advantage-overpayment-rule\">Read article here\u2026<\/a><\/p>\n<p><a href=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/court.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7787\" src=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/court-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/court-300x225.jpg 300w, https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/court.jpg 700w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<pre>Notice: The link provided above connects readers to the full content of the posted article. The URL (internet address) for this link is valid on the posted date; medicarereport.org cannot guarantee the duration of the link\u2019s validity. Also, the opinions expressed in these postings are the viewpoints of the original source and are not explicitly endorsed by AMAC, Inc.; the AMAC Foundation, Inc.; or medicarereport.org.<\/pre>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>On Friday, the U.S. District Court for the District of Columbia granted UnitedHealth\u2019s motion for summary judgement and vacated CMS\u2019s<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,21,9],"tags":[],"class_list":["post-11449","post","type-post","status-publish","format-standard","hentry","category-cms","category-health-care-finance","category-medicare-advantage"],"_links":{"self":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/11449","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11449"}],"version-history":[{"count":1,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/11449\/revisions"}],"predecessor-version":[{"id":11450,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/11449\/revisions\/11450"}],"wp:attachment":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11449"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=11449"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=11449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}