One health insurer says administering a major Patient Protection and Affordable Care Act (PPACA) subsidy program will be much more expensive than Obama administration officials think.
The program — the cost-sharing reduction (CSR) program — cuts out-of-pocket medical expenses for low-income exchange users. The Centers for Medicare & Medicaid Services (CMS) is already sending CSR cash to insurers, based on limited information about the enrollees. In 2015, the insurers and CMS are supposed to reconcile any gaps between what CMS paid in 2014 and what CMS should have paid.
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CMS officials say filing CSR reconciliation reports will cost an issuer less than $2,000 per year.
Kris Haltmeyer, a vice president at the Blue Cross and Blue Shield Association (BCSBSA), says one member told the association that the actuarial and technology services for the program will cost about $350,000 per year.
“CMS should revise the burden estimate sharply upwards, to more accurately reflect the true costs issuers will bear in complying with these reconciliation reporting requirements,” Haltmeyer writes in a comment letter sent to the federal Office of Management and Budget (OMB).
CMS is putting CSR information collection review efforts through a routine OMB review process.
The CSR program was created by PPACA Section 1402.