Judge’s $1.6B Ruling On Unpaid Subsidies Highlights Just How Much Trump Administration Could Have To Pony Up
The insurers' lawsuit against the federal government revolves around cost-sharing reduction subsidies that were intended to lower healthcare costs for certain people who bought coverage on the Affordable Care Act exchanges. While the judge's decision is likely to be appealed, it could foretell an expensive outcome for the administration.
Modern Healthcare:
Feds Owe Health Insurers $1.6 Billion In Unpaid Subsidies
A federal judge this week ordered the federal government to pay about 100 health insurance plans a total $1.6 billion in unpaid subsidies. While the government will likely appeal the case, the judgment illustrates the sheer magnitude of the funds the Trump administration could be forced to pay up. The insurers are part of a class action brought by Wisconsin-based Common Ground Healthcare Cooperative, which challenged the federal government's failure to pay cost-sharing reduction subsidies that were intended to lower healthcare costs for certain people who bought coverage on the Affordable Care Act exchanges. (Livingston, 10/24)
In other news —
Modern Healthcare:
CMS Delays New Primary-Care Pay Model, Calls For Providers To Join
The CMS on Thursday postponed the start of a new alternative payment model, but encouraged Medicare providers to apply and move toward value-based care. Both Primary Care First model options and the Kidney Care Choices model are voluntary payment models that aim to reform healthcare delivery by paying Medicare providers for the value of the care they provide and giving them incentives to manage chronic illness better. The Center for Medicare and Medicaid Innovation hopes that these programs will reward providers for boosting quality, improving patient satisfaction and cutting healthcare spending. (Brady, 10/24)
