News: CMS reinstates ACA risk-adjustment payments

CDI Strategies - Volume 12, Issue 34

A few weeks ago, CMS announced that it would be halting all risk-adjustment payments to insurers under the Affordable Care Act (ACA), causing a great deal of uncertainty at a time when insurance providers were developing premiums for 2019.

Last week, however, CMS reversed that decision and announced through a final rule that the agency would resume the payments under the ACA, HealthLeaders Media reported.

In the accompanying press release, CMS said that it issued the final rule because it determined “immediate action” is “imperative to maintain stability and predictability in the individual and small group health insurance markets.”

“Insurers that had expressed concerns about having to withdraw from markets or becoming insolvent should be assured by our actions,” said CMS Administrator Seema Verma in the press release.

According to America’s Health Insurance Plans (AHIP) President and CEO Matt Eyles, the rule did succeed in easing some uncertainty.

“The Administration has taken an important step to ensuring more affordable coverage choices are available for all Americans, including high-need patients and those with pre-existing conditions,” he wrote in a statement

Editor’s note: To read HealthLeaders Media’s coverage of this story, click here. To read the press release from CMS, click here. To read the statement from AHIP, click here. To read about the initial freeze and the precipitating events, click here.

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