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Highmark sues federal government over $220M unpaid ACA claims — 4 highlights

Health insurer Highmark is suing the federal government over $220 million unpaid claims, according to CNBC.

Here are four highlights:

1. Highmark claims the government owes the payer more than $220 million in claims it is owed under the Affordable Care Act.

2. Last fall, the Obama administration said it would not pay insurers the full amount owed under the risk-corridor program in 2014, when the program went into effect.

3. In 2014, the actual losses far surpassed predictions, leading the government to only pay insurers 12.6 percent of the money they initially offered. A spending law provision allows the government to only pay this portion of the claims.

4. Under the provision, the federal government paid insurers $362 million out of the $2.87 billion payers claimed for 2014. The government paid Highmark nearly $27 million.

More articles on coding & billing:
7 key findings on physicians not understanding medical test & procedure costs
Donald Trump, GOP agree ACA issue to emerge before 2016 presidential elections — 5 takeaways
Payer losses may double on ACA exchange in 2015, but market may remain viable — 5 things to know

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