Insurer Highmark Inc. filed a suit against the federal government, alleging that it is owed almost $223 million under the Affordable Care Act’s (ACA’s) “risk corridor,” reported MarketWatch.com.
Highmark, the insurance division of nonprofit Highmark Health in Pittsburgh, filed the suit Tuesday in the U.S. Court of Federal Claims.
The risk corridor program was designed to assist insurers that end up with larger costs than usual—particularly those insurers that choose to take in more high-risk consumers. The idea was that if an insurer’s actual claims are a percentage higher than its projected claims, then the federal government must reimburse up to half of the excess amount.
Highmark’s suit claimed that there were “violations of the mandatory risk corridor payment obligations prescribed” in the ACA.
Last fall, the Department of Health and Human Services announced that insurers participating in the risk corridor would initially receive only 12.6% of the money they claimed under the program for 2014—the first year the program was implemented.
The department has declined to comment on Highmark’s suit.
Previously, another insurer (Health Republic Insurance Co.) filed a similar suit in February seeking class-action status.
