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Biden’s HHS Defends Medicare Overpayment Rule in High Court Row

May 20, 2022, 9:39 PM

A rule requiring Medicare Advantage private insurers to refund overpayments was properly reinstated, the Department of Health and Human Services said in a brief filed with the U.S. Supreme Court.

Nothing in the Medicare law’s “actuarial equivalence” provision restricts the ability of the Centers for Medicare & Medicaid Services to require that insurers repay money they erroneously collected from the agency, the HHS said in opposition to UnitedHealthcare Insurance Co.‘s high court petition.

The 2014 overpayment rule established the method used by the CMS to determine insurer repayments when diagnostic codes used to adjust payments based on the relative ...