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Despite nearly $22M lawsuit, Maryland co-op to pay CareFirst BCBS $24.2M under risk-corridor program — 5 key notes

Under the Affordable Care Act's risk corridor program, Baltimore-based Evergreen Health, Maryland's co-op, will pay $24.23 million to CareFirst BlueCross BlueShield, according to The Baltimore Sun.

Here are five key notes:

1. In June, Evergreen Health filed a lawsuit against the federal government to avoid more than $22 million in fees. The co-op warned the risk corridor program "threatens the viability of the entire Affordable Care Act."

2. In its suit, Evergreen said the program works in favor of larger payers who have more resources to assess their members' health.

3. While the ACA created 23 co-ops to promote competition, Maryland remains one of the final contenders. In 2010, federal ACA grants totaling $65 million helped launch Maryland's co-op program.

4. Earlier this week, Connecticut's co-op, HealthyCT, was placed under supervision and started a "wind-down" process. Based on HealthyCT's current financial standing, more people cannot sign up for coverage with the co-op, and the state is cautioning existing enrollees to begin seeking new coverage when their plans expire.

5. In late June, Land of Lincoln Health, Illinois' co-op, sued the federal government for failing to pay the company nearly $72 million in payments the co-op claimed it was owed under the risk-corridor program.

More articles on coding & billing:
Following $90M losses, Illinois regulator signs order to prevent co-op from paying government: 6 things to know
CMS proposes 1.2% ASC payment increase in 2017: 9 key points
Federal judge rules parts of ACA are 'illegal' — 8 highlights

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