Appeals Court Judges Seem Disinclined To Let Insurers Recoup Loses From Cut To Cost-Sharing Reduction Payments
The federal government is arguing that insurers received increased subsidies when they raised premiums, which more than compensated their losses. Judges in the U.S. Court of Federal Claims have so far sided with insurers and ruled that their strategies to mitigate losses from CSR payments do not affect their eligibility for repayment. Meanwhile, states report their health law enrollment numbers.
Modern Healthcare:
Insurers Recouping Cost-Sharing Payments Concerns Judges
A three-judge panel of the U.S. Court of Appeals for the Federal Circuit on Thursday voiced concern that insurers could profit from recouping cost-sharing reduction payments mandated by the Affordable Care Act that the Trump administration stopped paying in October 2017. During oral arguments, the U.S. Justice Department argued that insurers received increased subsidies when they raised premiums, which more than compensated their losses from the CSR payments. (Cohrs, 1/9)
Roll Call:
Appeals Court Hears Arguments Over Health Care Cost-Sharing Subsidies
President Donald Trump halted the subsidies in 2017, prompting health care plans on the insurance exchanges across the country to increase their premium rates the following year. But Congress never appropriated specific funds for the subsidies, which the federal government argued ended the obligation of the Department of Health and Human Services to pay the plans. (Clason, 1/9)
The Advocate:
Obamacare Signups Fall To Record Low In Louisiana For Second Straight Year
The number of people who signed up for health coverage through Louisiana’s individual exchange fell to its lowest point on record for the second straight year in 2020, amid a double-digit rate hike and a Republican-backed lawsuit seeking to throw out the law. Enrollment in the Affordable Care Act’s individual market--commonly known as “Obamacare” – fell to 87,748 this year, from 92,948 last year. Nationwide, enrollment was relatively steady, dipping slightly to about 8.3 million in the 38 states that, like Louisiana, use the federal HealthCare.gov website. (Karlin, 1/9)
New Hampshire Public Radio:
Healthcare.Gov Enrollments Remain Stable In N.H. With 44,000 Signing Up
44,412 New Hampshire residents signed up for or switched their health insurance plans on healthcare.gov during the Affordable Care Act's open enrollment period. The number is just slightly down from last year's total of 44,581. (Moon, 1/9)
And in other news from the health industry —
Modern Healthcare:
Justice Department Recovered $2.6 Billion From Healthcare Fraud Cases In 2019
The U.S. Justice Department recovered more than $2.6 billion in 2019 from lawsuits involving healthcare fraud and false claims, federal data released Thursday show. The department's recoveries from healthcare fraud cases have inched higher in recent years from roughly $2.5 billion in 2018 and $2.1 billion in 2017. The fiscal year ending Sept. 30 was the 10th straight year that settlements and judgments from healthcare companies for alleged fraud exceeded $2 billion, the Justice Department said. (Livingston, 1/9)
The Associated Press:
Health Care Group Pays $2.17M After Releasing Patients' Info
A health care group based in Virginia has agreed to a settlement of almost $2.2 million after hundreds of patients' health information was wrongfully released. Sentara's settlement with the U.S. Department of Health and Human Services was one of the largest the agency sought to collect in 2019, The Virginian-Pilot reported Wednesday. (1/9)
