Day Pitney's Bill Goddard was quoted in an article, "U.S. Owes Health Insurance
Plans Billions in Risk Corridor Payments, Complaint Says," in
BNA's Health Law Reporter. In the article, Goddard discusses
Health Republic Ins. Co. v. United States (Fed Cl., No. 16-259,
filed 2/24/16), a case brought by an Oregon health insurance co-op.
The complaint alleges that the federal government
owes unpaid risk corridor payments to insurers, as recently
discussed
here and
here.
The Affordable Care Act (ACA) provided for the government to make
payments to insurers pursuant to three different programs designed
to compensate them for assuming greater-than-expected risks. Due to
funding constraints, only a fraction of the risk corridor payments
have been made, and the co-ops' financial losses have forced
many of them out of business. Of the 23 co-ops that were
established under the ACA, only 10 continue to write individual
health insurance policies.
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