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 ...

Newly finalized regulations from the federal government create a “next generation risk adjustment model” aimed at stabilizing the Affordable Care Act marketplaces. On Friday, the Centers for Medicare ...

Worcester-based Fallon Health and two other insurance plans have asked the state’s Health Connector Insurance Authority to review risk assessment fees that they say could financially impact smaller ...

Worries about what happens when issuers fail, or simply refuse to pay their risk-adjustment program bills. Whether the risk scores adequately reflect the relative risk of enrollees. Whether the issuer ...

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 ...

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 ...

For health plans serving the individual market, the Affordable Care Act’s risk adjustment program generally worked as intended to shift funds from insurers with low-cost enrollees to plans with ...

The Trump administration said it will restart the risk adjustment payment program just weeks after suspending the payments; the first pill in a decade has been approved to treat pain caused by ...

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 ...

You are able to gift 5 more articles this month. Anyone can access the link you share with no account required. Learn more. BANGOR (AP) — Maine Sen. Susan Collins says President Donald Trump’s labor ...

On July 7, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a press release confirming that about $10.4 billion in risk adjustment payments for 2017 will not be made until the ...