Anthem plans sue for $100M in federal payments

November 21, 2019

Anthem Blue Cross filed a lawsuit against the federal government to recoup $100 million in payments under the ACA, according to Bloomberg Law.

 

In the Nov. 18 lawsuit filed in the U.S. Court of Federal Claims, Anthem argued it sold plans on the ACA individual exchange because the government said it would offset expected losses on the policies through the risk corridors program. 

 

Risk corridors payments, which expired in 2016, aimed to protect insurers from large deficits as they enrolled sicker members into their new individual exchange policies. While the program intended to ensure insurers whose customers were more expensive than expected received payments while insurers with lower costs paid into the program, more insurers ended up needing payments than anticipated.

 

Anthem, which only received a fraction of its risk corridors payments, aims to recoup the remainder from the 2014-16 plan years. The complaint argues the government acknowledged it owes Anthem the payments.

 

Republicans blocked the federal government from making the risk corridors payments, arguing it was a bailout for insurance companies. Several other insurers sued and collectively argue they're owed more than $12 billion in risk corridors payments.

 

Anthem sold ACA exchange plans in 11 states, according to Bloomberg Law.

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