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CMS Proposes Rule for 2018 Risk Adjustment Payments

WASHINGTON -- The Centers for Medicare & Medicaid Services (CMS) continued its push to reinstate risk adjustment payments to health insurance plans, releasing a proposed rule to issue risk adjustment ... read more

CMS, In a Reversal, Announces Plans to Continue Funding Risk Adjustment Payments

On Wednesday, August 8, CMS filed a proposed rule clearing the way for the federal government to continue making payments under the ACA’s risk adjustment program for the benefit year 2018. The 2018 pr... read more

CMS Proposed Rule Aims to Secure 2018 Risk Adjustment Payments

August 13, 2018 - CMS has proposed a new rule that aims to resolve legal issues over the risk adjustment program’s payment methodology. The rule would ensure that payers will receive appropriate risk ... read more

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CMS proposes using 2018 benefit year methodology in risk adjustment payments

The CMS unveiled a proposal Wednesday to adopt the risk adjustment methodology established for the 2018 benefit year, which uses the statewide average premium, in calculating Affordable Care Act risk ... read more

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CMS proposes tweaks to 2019 Medicare Advantage risk-adjustment model

The proposed changes released last week are part of the 21st Century Cures Act passed in December 2016. That legislation required the CMS to improve the Medicare Advantage risk-adjustment ... old risk ... read more

CMS Issues New Proposed Regulation On Risk Adjustment Formula For 2018

On August 8, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a new proposed rule to readopt a portion of its risk adjustment methodology for the 2018 plan year. Similar to a recent f... read more

NM health co-op challenges new Obamacare risk payments

Health Connections since 2016 has been fighting the so-called risk adjustment program, which transfers payments from ... struck down other CMS regulations for similarly denying the public’s right to n... read more

New Mexico insurer urges judge: Scrap risk adjustment rule

Its initial decision to freeze the payment drew outrage from insurers. … But New Mexico Health Connections argues in a new legal filing that CMS violated the Administrative Procedure Act by failing to ... read more

New Mexico Carrier Sues Over Feds' ACA Risk-Adjustment Move

The Albuquerque, New Mexico-based insurer has asked the court to set aside emergency ACA risk-adjustment regulations that HHS and CMS ... payments for the 2017 benefit year. The insurer also filed a m... read more

New Developments In Risk Adjustment Litigation

Section 1343 of the Affordable Care Act (ACA) directed HHS to develop standards for the risk adjustment program, including a formula to make these payment ... a separate proposed rule regarding the ri... read more

Risk adjustment payments to be based on 2018 premiums, CMS proposes

CMS will use the statewide average premium for the 2018 benefit year in its risk adjustment payment calculations ... funds to insurers with more high-cost members. Prior to the proposed rule, CMS issu... read more

D.C. Week: CMS Plans Overhaul of Some Medicare ACOs

CMS Proposes Rule for 2018 Risk Adjustment Payments CMS continued its push to reinstate risk adjustment payments to health insurance plans, releasing a proposed rule to issue risk adjustment payments ... read more



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