Cooperating for better care.

News & Views

N.C. BCBS denounces Feds over risk-corridor payments

Share this:


Blue Cross and Blue Shield of North Carolina has denounced the federal government  for trying to avoid paying it  many millions of dollars in overdue risk-corridor payments.

Modern Healthcare reported: “Although the U.S. Justice Department recently said the insurer’s lawsuit and several others over the controversial three-year program are premature, since payments allegedly won’t be due until next year at the earliest, the North Carolina Blues said that argument runs afoul of the Affordable Care Act and history of the risk-corridor program.”

The insurer attacked the Feds’ recent  moves in a series of lawsuits over risk-corridor payments for 2014 and 2015. North Carolina BCBS alone is owed $147.5 million in overdue payments for its losses  on the Affordable Care Act exchange but so far, the Feds have only paid the insurer $18 million.

The Blues say the risk-corridor program was a major element in the insurer joining the insurance exchange in the state, as it hedged the impact of insuring new customers without necessary medical or actuarial data to help set premium rates. The Feds have touted the program over the years as a way to protect health plans.

Modern Healthcare reported that the Justice Department has asserted that the risk-corridor plan was meant to be budget-neutral, which BCBS disputes, pointing out that  the final rulemaking establishing the risk-corridor program stated  that the program was not going to be budget-neutral.

To read the Modern Healthcare article on this, please hit this link.

Contact Info

(617) 230-4965

Wellesley, Mass