The ACA risk-adjustment program was supposed to compensate health insurers that ended up with more than their fair share of the enrollees with serious health problems. (Image: Shutterstock)
Three federal appeals court judges have sided with UnitedHealth Group in a dispute with New York state insurance regulators.
A panel at the 2nd U.S. Circuit Court of Appeals has agreed with UnitedHealth that the superintendent of the New York State Department of Financial Services needed, and lacked, clear, formal approval from the U.S. Department of Health and Human Services (HHS) to add a state-level adjustment mechanism to the Affordable Care Act (ACA) risk-adjustment program.
In a ruling posted today, the 2nd Circuit panel reversed a district court dismissal and sent the case back to the district court for further consideration.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
