The Humana world headquarters building in downtown Louisville, KY.

Humana sued the Centers for Medicare & Medicaid Services on Sept. 1 in an attempt to block a Biden administration policy allowing Medicare to claw back billions of dollars from insurers for overcharges. The lawsuit said CMS “did not even try” to justify its more aggressive approach toward determining whether private Medicare Advantage plans were overpaid.

Humana objected to a rule announced in January that allows the government to recoup payments when audits uncover charges for diagnoses that are not in patients’ medical records. The insurer said the rule, which would apply retroactively, was “arbitrary and capricious” and threatened “unpredictable consequences for Medicare Advantage organizations and the millions of seniors who rely on the Medicare Advantage program for their health care.”


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