Are settlement talks between CMS & payers in the works? 4 takeaways

Many payers sued the federal government after they suffered huge losses on the Affordable Care Act’s risk corridor program, with CMS Acting Administrator Andy Slavitt saying the agency may be discussing possible settlements with payers, according to The Hill.

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Here are four takeaways:

1. At a hearing this week, Rep. Morgan Griffith (R-Va.) asked Mr. Slavitt if any CMS member was speaking with the Department of Justice about settlements with the payer, to which Mr. Slavitt said, “I know that our general counsel speaks to Justice regularly, so I assume that they have, but I don’t know any details.”

2. Settlement talks have sparked opposition from Republicans who claim the Obama administration is not abiding by Congress limitations and will dip into a separate “judgment fund” to evade congressional restrictions on funding.

3. Mandy Cohen, MD, a CMS official, did not comment as to whether CMS could use the judgment fund to pay the settlements. During a separate hearing, Dr. Cohen said, “I’d have to talk to my lawyers on that so I can’t speak to that.”

4. Mr. Slavitt said CMS has referred payers with questions about settlements to the DOJ.

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