Becker's Healthcare November 25, 2025
HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas.
The 2023 final rule allowed CMS to recover billions in suspected overpayments based on extrapolating audit results from a small sample of enrollees, court documents said.
The final rule cut the “fee-for-service adjuster” in MA audits. The adjuster intended to strike...
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