Medica Insurance Company v. Becerra

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA MEDICA INSURANCE CO., Plaintiffs, v. Case No. 1:22-cv-1440-RCL XAVIER BECERRA, Secretary of Health and Human Services, Defendant. MEMORANDUM OPINION This is an appeal from a decision of the Administrator of the Centers for Medicare & Medicaid Services (CMS) brought by Medica Insurance Company, a Health Maintenance Organization (HMO). The Administrator held that a formula used to calculate how much of Medica’s costs Medicare must reimburse cannot include certain charges from doctors that were erroneously billed to an entity other than…