9th Circ. Backs HHS Bar On Medicare Claim Reviews

Law360, Washington (September 11, 2012, 6:50 PM EDT) -- The Ninth Circuit on Tuesday upheld a lower court decision that lets the U.S. Department of Health and Human Services bar administrative reviews of contractors' decisions to reopen Medicare payment claims, saying the court couldn't overturn HHS' congressionally mandated discretion for setting review regulations.

According to the opinion, decisions by HHS' recovery audit contractors, or RACs, to reopen Medicare claims are protected from administrative and judicial appeals by Medicare providers thanks to regulations passed in 2005, which put regulatory enforcement solely up to the discretion of...
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