Becker's Healthcare October 30, 2023
Bright Health and Friday Health Plans are unable to meet their risk-adjustment payment obligations, leaving other insurers $1.1 billion short, CMS disclosed Oct. 27.
Bright Health exited the ACA exchange market at the end of 2022, and Friday Health Plans went out of business in June 2023.
In the ACA market, insurers must pay in risk-adjustment payments to CMS, designed to even out financial risk between payers with higher- and lower-risk enrollees in each market.
In September, Bright Health said it had entered a repayment agreement with CMS to pay the remaining $380 million it owed in risk-adjustment payments for 2022 over 18 months. The company owes $199 million in Florida, where it must pay $1,000 a...
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