Bad data forces CMS agency to put off publishing risk corridor program results

The data that health insurers submitted as part of the Affordable Care Act's risk corridor program contain a "significant number of discrepancies," meaning the federal government can't publish preliminary program results until it sorts it all out, according to a memo from the Center for Consumer Information and Insurance Oversight (CCIIO).

The CCIIO--which is part of the Centers for Medicare & Medicaid Services (CMS)--planned to publish preliminary estimates of payments and charges for its risk corridor program Aug. 14, but will have to postpone its publication of the results. It will need to conduct an additional validation of the data and may even need to ask some insurers to resubmit their data.

Though it gave no timeline for its publication of the results, the agency will "provide further information when the risk corridor data is accurate, complete and validated," the memo states.

The risk corridor program, in combination with reinsurance and risk adjustment, comprise the ACA's "three Rs," which aim to help health insurers manage the financial risk of covering a larger number of people. The programs have faced considerable criticism from those who deem them a "bailout" of the health insurance industry, and even the Government Accountability Office has expressed its doubts.

Federal government officials, however, have continually reiterated their support of the three Rs. The CCIIO memo notes that "CMS remains committed to the risk corridors program," and a recent letter from Healtcare.gov CEO Kevin Counihan to state insurance commissioners noted that CMS believes risk corridors collection will be sufficient to pay for all risk corridors payments.

The Department of Health and Human Services (HHS) also announced in late June that it will reimburse health insurers for 100 percent of certain high-cost claims for the 2014 benefit year. HHS was able to do so because insurers' reinsurance contributions exceeded the total requests for reinsurance payments.

To learn more:
- here's the memo

Related Articles:
ACA debate: Risk corridors, reinsurance, risk adjustment on the table
HHS can't unilaterally bail out insurers, GAO says
New CMS rule targets risk corridor program
Will insurers take a bath on risk corridors?
HHS expands transitional reinsurance program to cover 100 percent of some high-cost claims

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