The Centers for Medicare & Medicaid Services (CMS) asks CO-OPs to give CMS more information about their capital and surplus in monthly financial reports.
The new template also asks CO-OPs to give CMS more information about matters such as investment income receivables, Patient Protection and Affordable Care Act (PPACA) reinsurance program premium costs, and expected PPACA reinsurance program recoveries, according to a copy of a “crosswalk” spreadsheet that indicates how CMS is changing the template.
CMS says in a note at the bottom of the template that the information given in the template “has not been publicly disclosed and may be privileged and confidential.”
“All information will be kept private to the extent allowed by application, laws and regulations,” CMS says in a supporting statement.
PPACA drafters said they created the CO-OP program in an effort to increase competition in the commercial health insurance market. PPACA provided cash to the parent of CMS, the U.S. Department of Health and Human Services (HHS), could be used to offer CO-OP organizers startup loans. Some Republicans have argued that the CO-OPs are likely to fail. They succeeded at getting a provision cutting the amount of cash HHS has available to offer CO-OPs additional loans by 90 percent signed into law in 2013.
In exchange for the startup loans, the organizers had to promise to set up nonprofit, member-owned health insurance companies. Under the current law, CO-OPs cannot get financial support from health insurance companies, and they cannot sell the companies to insurance companies or other buyers.
Originally, CMS required the CO-OPs to send it financial reports every quarter. CMS shifted to a monthly CO-OP reporting schedule in January.