2018年11月6日

2018年11月6日3:54pm至少兩個計劃將請求最高法院聽到走廊風險情況。(sframephoto / iStock /蓋蒂圖片社加上/蓋蒂圖片社)一個聯邦上訴法院否認收購幾個保險公司的再審訴訟尋求收回走廊支付風險,為一個潛在的戰鬥在最高法院。今年夏天,美國聯邦巡回上訴法院裁定,美國衛生與公眾服務部(HHS)並不要求保險公司支付風險走廊。推翻了2017年由美國聯邦法院決定聲稱說美國衛生和公眾服務部未能履行承諾償還旨在保護保險公司從極端收益或損失對可支付醫療法案交流。緬因州Moda健康計劃,林肯的故鄉社區衛生選項和北卡羅萊納藍十字藍盾請求聯邦巡回法院審理該案的法官的整個小組。周二,9 11法官拒絕了(PDF)的請求。Moda健康計劃,保險公司主要訴訟反對美國衛生和公眾服務部,計劃上訴最高法院的決定。“很明顯我們很失望,今天的決定,”羅伯特•Gootee總裁和首席執行官,FierceHealthcare Moda公司在一份聲明中說。“我們繼續認為,審判法庭,我們政府的義務中清楚地說明。我們將尋求最高法院的審查。” Stephen McBrady, an attorney with Crowell & Moring who represents Maine Community Health Options, said the insurer also intends to appeal. “Maine Community Health Options is a non-profit health plan that went into the exchanges and performed exactly as the Affordable Care Act required, providing healthcare coverage to thousands of previously uninsured and underinsured Maine citizens,” he said in an emailed statement. “The health plan filed its risk corridors law suit in order to enforce the government’s obligation to perform as the government was required under the ACA. Today’s ruling is disappointing, but Maine Community Health Options intends to appeal to the Supreme Court.” Following the Federal Circuit Court’s June decision, University of Michigan law professor Nicholas Bagley wrote in the Incidental Economist that the case is “not an implausible candidate for review… but the Court might be gun-shy about wading into another case about the ACA.” Notably, two judges on the federal circuit—Pauline Newman and Evan Wallach—dissented, calling the case a “question of the integrity of government” with a financial impact on insurers across the country. “Our system of public-private partnership depends on trust in the government as a fair partner,” Newman wrote. “And when conflicting interests arise, assurance of fair dealing is a judicial responsibility.” As of last year, the government’s unpaid risk corridor tab had swelled to $12.3 billion . That brought dozens of lawsuits from insurers like Moda, Humana and Molina Healthcare, which claimed they were owed hundreds of millions in payments. Read more on