Issuers meet risk corridor program deadlines, CMS postpones results

The Center for Medicare and Medicaid Services’ Center for Consumer Information and Insurance Oversight (CCIIO) announced that most issuers of qualified health plans (QHPs) met the proscribed deadlines for the risk corridors and medical loss ratio (MLR) forms for the temporary risk corridor program. Yet the agency’s memorandum also indicated that it would not publish these results to the public at the anticipated date of release, August 14, 2015, due to the need for additional data validation.

Preliminary risk corridor program. CMS created the temporary risk corridor program, which requires all QHPs that offer plans on the health insurance exchanges created by the Patient Protection and Affordable Care Act (ACA), to submit information on risk corridors. The purpose of this temporary reporting is to help insurers set premium rates in the first few years of the individual and small-group market roll out after the implementation of the ACA. This is the first year that the reporting requirements were in place.

Deadlines, delay. In its announcement, CMS reported that the majority of QHP’s met the reporting requirement deadline of July 31, 2015, with the submission of risk corridor information and MLR forms. Yet, CMS would not be able to reveal these results at the specified time in mid-August because “while conducting quality assurance of the risk corridor data, we have identified a significant number of discrepancies in the data, which makes it necessary to conduct additional data validation,” said the memorandum issued by the CCIIO. The review of the information would include a comparison of the risk corridor data with other CMS data.

CMS noted that it would provide further information on the release of the information once the risk corridor data was “accurate, complete, and validated,” and that it would contact any issuer if CMS determines it will be required to resubmit any reported information.

SOURCE: CCIIO Memorandum, August 7, 2015.

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