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May 16, 2019

SCOTUS to Review Issues Surrounding Risk Corridor Payments

In the ongoing battles over the ACA and its component parts, the lawsuit brought by a number of payors arguing that the Trump Administration must pay risk corridor payments is headed for the Supreme Court. The trial courts ruled for the managed care companies, determining that the federal government owed the money, but the US Court of Appeals for the Federal Circuit reversed, saying that the original intent of the ACA related to risk corridor payments was suspended by Congress’ decision not to fund the program, based on its intent that the ACA be budget neutral. The appeal argues that the ACA created the risk corridors as a temporary program and left it up to future sessions of Congress to decide whether to continue appropriating funds.