Insurers can't correct certain data filing errors, CMS bulletin says

In a recent bulletin, the federal government addresses incorrect data submission under the Affordable Care Act's reinsurance and risk adjustment programs for the 2014 benefit year. As the Centers for Medicare & Medicaid Services (CMS) notes, "an overstatement or understatement of diagnoses or other factors driving an issuer's risk score will have a uniform effect on the risk adjustment transfers for the other issuers in the market." Insurers that provided incorrect claims or diagnosis data cannot change that at this point, as it unlikely to negatively affect other insurers and "our EDGE server deadlines have been clear," the bulletin states. However, "in cases where there is a material impact on risk adjustment transfers for that particular market as a result of incorrect EDGE server premium data," CMS will take steps to correct the inbalance. Announcement

 

Suggested Articles

Blue Cross and Blue Shield of North Carolina and Cambia Health Solutions have jointly decided to end their talks to enter a "strategic affiliation."

The Trump administration's new rules to overhaul the Stark Law have some areas that could create major regulatory headaches.

Medicare Part D beneficiaries could see their out-of-pocket costs go up next year before they reach catastrophic coverage, a new analysis shows.