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.

0 Comments
© 2024 MMIT
Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

Related Posts

medicare-part-c
May 17

Medicare, Medicaid Segments May Be a ‘Mess,’ but Bounce-Back Expected

READ MORE
hospital-hallway
May 17

As Hospitals’ Commercial Prices Keep Rising, Experts Float Solutions

READ MORE
businessman-viewing-news-update-journalism-headline-on-a-laptop
May 17

News Briefs: CMS Extends Medicaid Redetermination Deadline

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today