Blue Cross and Blue Shield of North Carolinas (BCBSNC) says the federal government is trying to run out on a bill that amounts to $147.5 million in overdue risk-corridor payments. The Justice Department counters that the suit—along with several others that revolve around the 3-year-old program—is premature because any payments wouldn’t be due until next year at the earliest. BCBSNC is eager to have its day in court though, and says the government’s defense is “revisionist history.” The insurer says the risk-corridor program was key to its joining the Affordable Care Act (ACA, or “Obamacare”) insurance exchange in the state. The government promoted the risk-corridor program as a way for qualified health plans to limit financial risk for years. More recently, though, it has claimed the risk-corridor plan was meant to be budget-neutral. The Justice Department’s pivot started in early October, after the Centers for Medicare and Medicaid Services said it would not make its 2015 risk-corridor payments because the collections would be used to pay a $2.5 billion gap in program funding from 2014.
North Carolina Blues Throw Down the Gauntlet with Feds