Becker's Healthcare August 9, 2018
The risk adjustment program was established under the ACA to encourage insurers to participate in the ACA marketplace and accept all customers without charging more for patients in need of substantial medical services. In addition, it was put in place to protect insurance companies from major losses. The program collects money from insurers with fewer high-cost members and transfers those funds to insurers with more high-cost members.
Prior to the proposed rule, CMS issued a final rule July 24 that...
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