Texas Court Order Complicates Bright Health’s Risk Adjustment Repayments

The saga of Bright Health Group, Inc. became even more complex on Nov. 29, when the troubled health insurer’s plan to remit unpaid risk adjustment fees to CMS was partially blocked by a Texas state judge at the prompting of the Texas Dept. of Insurance (TDI). The Texas court’s action will compel Bright to complete the receivership process for its Texas subsidiary and pay off creditors with claims in Texas before sending any capital to the federal government or other out-of-state creditors, experts say — that is, if there is any money to send somewhere in the first place.

“I know that there’s some talk now that Texas will be at the back of the line for purposes of CMS or any of the Texas plans that would have gotten the risk adjustment money, in terms of being able to collect on that,” Leah Stewart, an attorney at Reed Claymon PLLC, tells AIS Health, a division of MMIT. “I think politically they [Texas officials] probably don’t care that it impacts CMS’s deal with Bright Health. But I don’t know that they were actually angling for that, as opposed to just deciding that Bright Health of Texas doesn’t have enough money and taking it down the standard liquidation path.”

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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