Crowell & Moring Says Feds Owe NY Health Insurer More Than $38.7M
A western New York health insurer has filed a lawsuit against the federal government arguing that it is owed more than $38.7 million from the risk corridor program under the Affordable Care Act.
August 22, 2017 at 06:00 PM
10 minute read
A western New York health insurer has filed a lawsuit against the federal government arguing that it is owed more than $38.7 million under an Affordable Care Act program designed to incent insurers into participating in public health exchanges.
HealthNow New York Inc., the parent company of BlueCross BlueShield of Western New York, filed a lawsuit in the U.S. Court of Federal Claims in Washington, D.C., on Aug. 11, arguing that the federal government was in “breach of its risk corridor payment obligation under an implied in-fact contract.”
A lawyer for the Buffalo-based insurer, Stephen McBrady of Crowell & Moring, argued in the lawsuit, HealthNow New York v. The United States of America, Number 17-1090C, that the Centers for Medicare & Medicaid Services concedes that it owes HealthNow $9.6 million under the risk corridor program for participating in the New York health exchange marketplace in 2015. The complaint alleges that CMS also owes an additional $29.1 million for participating in the state marketplace in 2016. According to the lawsuit, HealthNow provided insurance coverage to 56,000 people between 2014 and 2016.
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