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Administration Says Risk Corridor Complaint Not Actionable

Publisher: Bloomberg BNA Law Reports: Daily Report for Executives, Health Care Daily Report and Health Care Insurance Report
June 30, 2016

Bill Goddard was quoted in an article, "Administration Says Risk Corridor Complaint Not Actionable," in the Bloomberg BNA Law Reports: Daily Report for Executives, Health Care Daily Report and Health Care Insurance Report. Goddard was quoted in the article on the case Health Republic Ins. Co. v. United States, in which government attorneys moved to dismiss arguments in federal court about the government's failure to pay health insurers funds they say they were promised under the Affordable Care Act. Under the three-year risk corridor program, which is set to expire in 2016, insurers were to be compensated by the government if their actual spending exceeded expectations by more than. a specified percentage.  The suit alleged that didn't happen, due to funding constraints. Goddard told Bloomberg BNA that whether the claims are ready to be litigated depends upon how one views the risk corridor program. If each of the risk corridor program's three years is considered to be a discrete one-year program, then the claims should be ripe as to the 2014 payments. If, however, it is viewed as a whole, in which a single pool of money is collected that may be paid out over three years, then the ripeness question will need to be decided.


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