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
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The U.S. District Court for the Middle District of Tennessee June 30 denied a motion for a preliminary injunction by AbbVie in its lawsuit against the state’s…
Headline
The Supreme Court June 27 voted 6-3 to uphold an Affordable Care Act provision creating an independent task force charged with making recommendations of…
Perspective
In the next few days, Senate Republican leaders plan to unveil and vote on their updated reconciliation bill, which, as currently constructed, would have far-…
Headline
The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior…
Headline
The AHA this week is launching a new ad urging Congress to protect access to hospital care as it considers legislation that could have far-ranging negative…