The Trump administration has released proposed payment rates in Medicare Advantage (MA) and Part D for the 2027 plan year, ...
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 ...
The Centers for Medicare and Medicaid Services has reestablished the risk adjustment payments it froze earlier this month due to a court case over the program and, as such, will be paying out $10.4 ...
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 ...
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.
Connecticut Insurance Commissioner Katharine L. Wade moved to protect existing policyholders after HealthyCT learned June 30, 2016, it would have to pay CMS $13.4 million under the ACA Risk Adjustment ...
In a new final rule, CMS reissued the Affordable Care Act's risk adjustment program for payers in the ACA exchanges for the 2018 benefit year. The reissue includes an additional explanation of the ...
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