RADV Ruling: A Legal Earthquake in Medicare Advantage
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RADV Ruling: A Legal Earthquake in Medicare Advantage
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About this listen
In this episode of Health Law Simplified, hosts Sandy and Elizabeth unpack a pivotal federal court ruling that vacates a key CMS rule governing RADV audits in Medicare Advantage. Learn why the court struck down CMS’s extrapolation methodology and elimination of the Fee-for-Service Adjuster, and what this means for MA plans, compliance teams, and future rulemaking. We explore the procedural missteps that led to the ruling, its alignment with broader judicial scrutiny of CMS, and the potential ripple effects across the industry. Plus, hear practical insights on how MA organizations can respond and prepare for what’s next.
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