CMS Postpones Release of Payment Data for Risk Corridors

CMS has delayed releasing data on risk corridors payments made to insurers under the Affordable Care Act, Modern Healthcare reports.

Background

Under the ACA, the risk corridors provision permits federal payments to health insurers to help offset the costs they might incur by enrolling a higher-than-expected number of sick people through the insurance exchanges.

The program, which will end after 2016, is meant to help insurers in the early years of establishing premium rates for individual and small-group insurance markets under the ACA. If insurers lose money on exchange plans above an expected limit, HHS will reimburse a designated amount of their losses. However, companies with better-than-expected medical expenses will have to return some money to the government.

Discrepancies in the Data

According to Modern Healthcare, insurers that sold plans on the federal exchange needed to submit data on the risk corridors program by July 31. CMS planned to disclose the information Aug. 14.

However, the release has been pushed back because of inconsistencies in the data.

In a memo, CMS wrote, "While conducting quality assurance of the risk corridors data, we have identified a significant number of discrepancies in the data, which makes it necessary to conduct additional data validation."

Cathy Murphy-Barron, vice president of health issues at the American Academy of Actuaries, said, "CMS has never collected any of this data before," adding, "Any time you deal with data, it takes longer than you think" (Herman, Modern Healthcare, 8/10).