Fierce Health Payers August 5, 2019
Insurers could owe the federal government under newly adjusted totals for the ACA’s risk adjustment program.
The Trump administration released changes to what Affordable Care Act insurers will receive or owe under the law’s risk adjustment program to reflect new data validation.
The Centers for Medicare & Medicaid Services released a report on Aug. 1 that details how data validation has affected the program’s totals for 2018. The goal is to increase the accuracy of payments and collections for risk adjustment, which has been the subject of several lawsuits from insurers.
Risk adjustment pays ACA insurers with a sicker population and collects money from insurers with low-risk populations. The goal is to reduce incentives for insurers to ignore...
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