Ramping up the controversy surrounding the Affordable Care Act’s risk adjustment program, two more health insurers have sued the federal government over what they see is a flawed formula that unfairly ...

Federal regulators will need to modify the Affordable Care Act (ACA) risk adjustment program if policymakers make changes to the individual and small group health insurance markets, according to a new ...

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 ...

The New York State Department of Financial Services issued an emergency regulation to address unequal impacts some small group insurers face under CMS’ risk adjustment program. Under the Affordable ...

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 ...

For health plans serving the individual market, the Affordable Care Act’s risk adjustment program generally worked as intended to shift funds from insurers with low-cost enrollees to plans with ...

A federal appeals court earlier this week upheld the HHS' methodology for running the Affordable Care Act risk-adjustment program, which will hurt small insurers that have argued the program is flawed ...

On June 30, the Centers for Medicare and Medicaid Services (CMS) released its report on the Affordable Care Act’s (ACA) risk-adjustment and reinsurance programs for benefit year 2015. Less than a week ...

Worries about what happens when issuers fail, or simply refuse to pay their risk-adjustment program bills. Whether the risk scores adequately reflect the relative risk of enrollees. Whether the issuer ...

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 ...