In a very interesting case, several California counties are suing Medicare claiming that the Medicare payment formula results in underpayments in rural communities that have undergine urbanization. According to the article, doctors in North Carolina may be among the most affected by the old formula. The case, which is brought as a class action, contends that the U.S. Department of Health and Human Services has failed for more than a decade to adjust appropriately for certain geographical differences in the cost of providing care. According to the article, doctors in North Carolina may be owed as much as $177 million in back pay. Click here for the article.