CMS to resume risk adjustment transfers for 2014-2016 benefit years
The Centers for Medicare & Medicaid Services next month will begin collecting and distributing risk adjustment payments in the permanent risk adjustment program for benefit years 2014-2018, the agency announced yesterday. The 10th Circuit Court of Appeals in December reversed a district court decision that invalidated CMS's use of the statewide average premium in its risk adjustment transfer formula for the 2014-2018 benefit years. The permanent risk adjustment program, created by the Affordable Care Act, transfers funds in the individual and small group health insurance markets from health plans with lower-risk enrollees to plans with higher-risk enrollees to spread the financial risk and help stabilize premiums.
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