Blue Cross and Blue Shield of North Carolina’s lawsuit against HHS for failing to pay $130 million owed under the Affordable Care Act (ACA)’s risk corridor program was tossed out by a federal claims judge, saying the agency isn’t required to make those payments annually, according to the National Law Journal.
Risk corridor was one of several mechanisms designed to shield insurers from losses in the early years of the ACA exchanges. Congress, however, later required the program to be budget-neutral, and with far more companies requesting money than paying into the program, the agency was only able to fulfill 12.6 percent of what insurers requested in its first year.
HHS said it’s still working through unpaid requests from 2014. While the insurer argued the agency was obligated to make full, annual payments, Judge Lydia Kay Griggsby said the ACA is “silent and, thus, ambiguous” on the timing of the payments.
Illinois insurance co-op Land of Lincoln was handed a similar ruling last year, but in other cases, judges have sided with the insurer.
Read more on the North Carolina case at the link below:
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.