With Risk Corridors Suits Settled, CSR Cases Heat Up

Fresh off winning a Supreme Court case concerning billions of dollars’ worth of payments from the Affordable Care Act risk corridors program, health insurers that operate in the ACA exchanges are racking up lower-court victories and filing new lawsuits over halted cost-sharing reduction (CSR) payment funding.

In mid-July, the U.S. Court of Federal Claims ordered the federal government to pay L.A. Care Health Plan more than $16.7 million in CSR payments that it withheld in 2019. Combined with a summary judgment made last year in L.A. Care’s favor regarding 2017 and 2018 payments, federal courts have ruled that the insurer is owed a total of $35.4 million. Even more recently, Humana Inc. on Aug. 10 filed a complaint in federal claims court arguing that it is owed just under $2 million in CSR payments for 2017.

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