Medical Advantage Overpayment Rule Vacated. Now What?
US District Judge Rosemary Collyer sided with UnitedHealth Group and said the final rule “will inevitably fail to satisfy the statutory mandate of actuarial equivalence.”
Stephanie told HealthLeaders “the ruling essentially invalidates CMS's 2014 final rule implementing the 60-day overpayment return requirement in the Affordable Care Act. Medicare Advantage Plan sponsors—such as UnitedHealth—still must comply with the ACA requirement to report and return any overpayment ‘after reconciliation’ within 60 days after the date on which the overpayment was identified.”
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