Ramping up the controversy surrounding the Affordable Care Act’s risk adjustment program, two more health insurers have sued the federal government over what they see is a flawed formula that unfairly ...
On December 31, 2019, a three-judge panel of the Tenth Circuit Court of Appeals upheld the methodology adopted by the Department of Health and Human Services (HHS) to administer the risk adjustment ...
On December 7, 2018, the Centers for Medicare and Medicaid Services (CMS) released a new final rule on the risk adjustment methodology for the 2018 plan year. The final rule made no changes from the ...
The Final Rule. In a Final Rule posted by CMS last Tuesday, July 24, 2018, CMS announced that $10.4 billion in “risk adjustment transfers” (“Risk Transfers”) for benefit year 2017 (as calculated ...
On June 30, the Centers for Medicare and Medicaid Services (CMS) released its report on the Affordable Care Act’s (ACA) risk-adjustment and reinsurance programs for benefit year 2015. Less than a week ...
The New York State Department of Financial Services issued an emergency regulation to address unequal impacts some small group insurers face under CMS’ risk adjustment program. Under the Affordable ...
To maximize shared savings, mastering risk adjustment is a critical factor for Accountable Care Organizations (ACOs) participating in MSSP, ACO REACH, and other alternative payment models.
The Trump administration announced Saturday that it will temporarily halt billions of dollars in payments under the Affordable Care Act’s risk adjustment program, a move that could shake up insurance ...
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