The Centers for Medicare & Medicaid Services is trying to decide just which plans will and will not qualify for help from one of the three major new health law risk management programs.
CMS talks about the “risk corridor” program eligibility rules in final regulations set to appear in the Federal Register this week.
The Patient Protection and Affordable Care Act is supposed to create the risk corridor program along with a temporary reinsurance program and a permanent risk adjustment program.
The temporary risk corridor program would take cash from exchange plans with claims costs much lower than expected and shift the cash to plans with claims much higher than expected.
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The risk corridor program is supposed to be limited to exchange plans. A plan offered both inside and outside the exchange program would be eligible.