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Health Insurance › Reimbursements › Remand

ArentFox Schiff

Federal Court Finds Provider/Payer Medicare Advantage Agreements Do Not Implicate Federal Question Jurisdiction

ArentFox Schiff on

A North Carolina federal court’s recent order granting remand in the case Nash Hospitals, Inc. v. UnitedHealthcare of North Carolina, Inc., et al., No. 5:25-CV-28-FL underscores the limits of federal question jurisdiction in...more

Morgan Lewis

High Court Checks Government in Risk Corridors Case

Morgan Lewis on

In Maine Community, the US Supreme Court found on April 27, 2020, that the Risk Corridors program created by Congress was a “money-mandating obligation” requiring the federal government to make payments under Section 1342 of...more

Ballard Spahr LLP

Health Insurance Exchanges: A $12B Judgment

Ballard Spahr LLP on

The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in...more

Akerman LLP - Health Law Rx

SCOTUS Rules Government Must Pay $12 Billion to Unprofitable ACA Insurers

Akerman LLP - Health Law Rx on

Despite Congress’ efforts to use riders to neutralize a provision of the Affordable Care Act (ACA or Act), the Federal government (Government) owes certain insurers $12 billion....more

Troutman Pepper Locke

Supreme Court Finds Insurers Entitled To Millions In ACA Payments

Troutman Pepper Locke on

On April 27, the U.S. Supreme Court held that the federal government is on the hook for $12 billion it failed to pay insurers under the Affordable Care Act (ACA) risk-mitigation program known as the Risk Corridors Program. ...more

Epstein Becker & Green

Supreme Court: The ACA & Risk Corridor Obligations

Epstein Becker & Green on

The U.S. Supreme Court decision in Maine Community Health Options v. United States, is a major decision affecting healthcare and resolving a significant Obamacare dispute. The Affordable Care Act famously established online...more

Sheppard Mullin Richter & Hampton LLP

Supreme Court Issues Long Awaited Ruling on Affordable Care Act Risk Corridors Program

Sheppard Mullin Richter & Hampton LLP on

The Supreme Court issued a long-awaited ruling on April 27, 2020, directed at a more than $12 billion challenge related to the temporary risk corridors program established by the Affordable Care Act (the “ACA”). Challenges...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Moda Health Plan, Inc. v. United States

Faegre Drinker Biddle & Reath LLP on

On April 27, 2020, the U.S. Supreme Court decided Moda Health Plan, Inc. v. United States, holding that the Affordable Care Act requires the federal government to compensate insurers for significant losses their health plans...more

Seyfarth Shaw LLP

Supreme Court Rules Government Must Pay $12 Billion to Health Insurers Under ACA Risk Corridor Program

Seyfarth Shaw LLP on

On April 27, 2020, the US Supreme Court ruled by an 8-1 decision that the federal government must pay billions of dollars to health insurers who sold consumer policies on exchanges under the Affordable Care Act’s (“ACA”)...more

Troutman Pepper Locke

Supreme Court Rules 8-1 That Government Must Pay Health Insurers Under ACA Risk Corridor Program

Troutman Pepper Locke on

In a major win for health insurers, the U.S. Supreme Court ruled in an 8-1 decision that the federal government owes roughly $12.3 billion to health insurers who claimed losses under the risk corridor program of the...more

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