Massachusetts, New Hampshire insurer sues government
CONCORD, N.H. (AP) — A nonprofit health insurer with 25,000 customers in Massachusetts and New Hampshire has filed a federal lawsuit claiming it is being illegally punished for offering lower-cost products.
Under the Affordable Care Act's risk adjustment program, insurers with healthier customers make payments to insurers with sicker customers. Boston-based Minuteman Health, a nonprofit insurance co-op, recently was ordered to pay $16.7 million, but it objects to how payments are calculated.
In a lawsuit filed Friday, it argues that instead of assessing only a consumer's relative health status or actuarial risk, the program calculates payments based on unrelated factors such as how an insurer's premiums compare to statewide averages. Minuteman says its premiums are substantially lower than average not because its customers are healthier but because its business model focuses on keeping costs low and because its members are more likely to purchase less-expensive plans.
"Perhaps the most troubling aspect of the Risk Adjustment program is that it isn't putting insurers on a 'level playing field' as intended," the lawsuit states. "Instead, CMS is picking winners and losers."
Read more: http://lacrossetribune.com/business/massachusetts-new-hampshire-insurer-sues-government/article_77d16475-683a-5bd8-8ec1-6be9f24b98ad.html
Cross-posted in the Massachusetts Group.