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 ...

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 ...

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 ...

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 ...

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 ...

Leavitt Partners: What major insurers have to say about CMS’ risk adjustment program The Patient Protection and Affordable Care Act (ACA) introduced restrictions on underwriting and new federal ...

To maximize shared savings, mastering risk adjustment is a critical factor for Accountable Care Organizations (ACOs) participating in MSSP, ACO REACH, and other alternative payment models.

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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 ...