Twenty-eight health care organizations, including the AHA, yesterday urged the Centers for Medicare & Medicaid Services to reconsider its decision to suspend $10.4 billion in risk adjustment transfers to insurers for 2017 until certain litigation is resolved. “We are very concerned that this move will create further uncertainty in the marketplace, negatively impacting patients’ access to affordable and comprehensive coverage, and lead to higher premium increases next year,” the organizations wrote. In February, a federal district court in New Mexico invalidated CMS’s use of the statewide average premium in the risk adjustment transfer formula for the 2014-2018 benefit years, pending further explanation of the agency’s reasons for operating the program in a budget neutral manner in those years. The groups urged CMS to seek other possible options to resolve the issues raised by the litigation. “For example, CMS could issue an expedited rule using the same rationale it used for the risk adjustment payment methodology in the final rule on Notice of Benefit and Payment Parameters for 2019,” they said.
 

Related News Articles

Headline
Responding March 15 to a House Committee on Education and the Workforce request for comments on ways to strengthen the Employee Retirement Income Security Act…
Headline
The Centers for Medicare & Medicaid Services March 15 announced flexibilities to help states initiate interim Medicaid payments to health care providers…
Headline
A federal court March 8 vacated the National Labor Relations Board’s 2023 rule for determining joint-employer status under the National Labor Relations Act and…
Headline
The Centers for Medicare & Medicaid Services March 7 invited drug makers in the Medicaid Drug Rebate Program that make federally approved gene therapies…
Headline
The House March 6 voted 339-85 to pass a package of six appropriations bills that would fund certain federal agencies through fiscal year 2024 and contains…
Headline
The Justice Department’s Antitrust Division, Federal Trade Commission and Department of Health and Human Services seek public input through May 6 on increasing…