UnitedHealthcare Sues HHS Over Medicare Advantage Overpayment Rule
The 41 UnitedHealth Group companies say the regulation will result in underpayment to insurers. In other news, the administration nears its goal for revamping the way Medicare providers are paid.
UnitedHealthcare Takes Aim At Medicare Advantage Overpayment Rule
Forty-one companies under the UnitedHealth Group umbrella, led by UnitedHealthcare Insurance Co., have set their sights on blocking Medicare Advantage regulations governing the returning and reporting of overpayments by filing suit against the Secretary of Health and Human Services in a federal district court in Washington. The suit, filed last week claims that the rule on overpayments promulgated by the Centers for Medicare and Medicaid Services in 2014 doesn’t follow the text of the Medicare Act, which requires that CMS assess the health status traditional fee-for-service Medicare participants and Medicare Advantage participants similarly. (Loughran, 2/3)
Drive To Focus Medicare Dollars On Quality-Based Care Nears Goal
Health and Human Services Secretary Sylvia Mathews Burwell announced one year ago that 30 percent of all Medicare payments would be based on value by the end of 2016, up from the current level of about 20 percent. “We think we’ll reach that goal,” Dr. Patrick Conway, chief medical officer for the Centers for Medicare and Medicaid Services (CMS), said at an event hosted by The Hill on Tuesday. That 30 percent commitment marks the most dramatic shift in Medicare payments in the program’s 50-year history. It’s also the first time the Obama administration — or any administration — has set a target on value-based payments. (Ferris, 2/4)