On December 31, 2019, a three-judge panel of the Tenth Circuit Court of Appeals upheld the methodology adopted by the Department of Health and Human Services (HHS) to administer the risk adjustment ...

Risk adjustment payments correlated for 2014 correlated highly with reinsurance program payments, showing that risk adjustment payments were going to insurers with high-cost cases; Risk adjustment ...

Newly finalized regulations from the federal government create a “next generation risk adjustment model” aimed at stabilizing the Affordable Care Act marketplaces. On Friday, the Centers for Medicare ...

Obamacare is kind of like an elaborate spaceship circling a black hole. It's a complex and desperate effort to avoid falling into the black hole of an adverse selection death spiral in which insurance ...

In response to criticism from some health insurers, federal regulators are considering some changes to the Affordable Care Act's risk adjustment program starting in 2018. The Centers for Medicare & ...

In future rulemaking, the Centers for Medicare and Medicaid Services will propose that all issuers fund a small payment to the risk adjustment program to help marketplace insurers with high claims ...

Worcester-based Fallon Health and two other insurance plans have asked the state’s Health Connector Insurance Authority to review risk assessment fees that they say could financially impact smaller ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

The Trump administration said it will restart the risk adjustment payment program just weeks after suspending the payments; the first pill in a decade has been approved to treat pain caused by ...