Sioux Falls, S.D.-based Sanford Health filed a lawsuit against the federal government, claiming officials owe Sanford approximately $9 million in risk-corridor payments, the Argus Leader reports.
Here's what you should know.
1. The federal government paid payers risk-corridor payments to help insurers offset uncertainties associated with selling individual plans on the ACA.
2. Sanford is joining 20 other payers that are suing the government to recover missed payments. Congress prohibited HHS from using certain accounts to make risk payments resulting in insurers foregoing billions of dollars.
3. After payers agreed to participate, the federal government attempted to make the ACA revenue neutral. Government officials believed revenues from the ACA would offset losses. In 2010, insurers paid $362 million into risk corridors but fielded losses of $2.87 billion, The Argus Leader reports.
4. In an emailed statement to Becker's ASC Review, Sanford Health Chief Marketing Officer Cindy Morrison stated, "Sanford Health Plan has followed the law and brought high-quality, affordable health insurance to the people of South Dakota, North Dakota and Iowa. The law and the risk corridors program imposed payment requirements on Sanford Health Plan, which it has met. It also imposed payment obligations on the government. Unfortunately, the government has not met its payment obligations, and Sanford Health Plan has brought this lawsuit in order to ensure that the government lives up to its end of the bargain."