Health Affairs October 25, 2019
On October 22, 2019, Judge Margaret M. Sweeney issued a final decision in a class action lawsuit brought by insurers over unpaid cost-sharing reduction (CSR) payments. She held that the estimated 100 insurers in the class are owed nearly $1.6 billion in unpaid CSRs for 2017 and 2018.
The ruling itself was no surprise: Judge Sweeney held in February 2019 that these insurers were entitled to unpaid CSRs. (She has reached the same conclusion in other challenges brought by individual health insurers.) In her February decision, she held that insurers were owed unpaid CSRs for both 2017 and 2018 even though many insurers used “silver loading” to make up for unpaid CSRs in 2018. The total amount in unpaid CSRs...
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