Healthcare DIVE September 26, 2025
On Thursday, Texas Judge Reed O’Connor threw out a Biden-era rule that would have recouped billions of dollars in overpayments to MA plans.
Dive Brief:
- A federal judge has thrown out a Biden-era rule that would have clawed back billions of dollars in overpayments from Medicare Advantage insurers in a major win for the industry.
- On Thursday, Judge Reed O’Connor of Texas’ Northern District vacated the Medicare Risk Adjustment Data Validation, or RADV, rule, determining that the CMS didn’t properly notify the industry about the changes in violation of the Administrative Procedures Act.
- The ruling complicates the CMS’ plan to beef up audits of MA payers and more broadly crack down on overpayments in the privatized Medicare program.
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