Health Affairs Mentions L.A. Care as CMS Addresses Cost Sharing Reductions

Wednesday, April 10, 2019

Health Affairs mentioned L.A. Care in "CMS Finalizes Rate Review Timeline, Issues Guidance on CSR Reconciliation, and More". The blog details how the Centers for Medicare and Medicaid Services (CMS) has begun to issue guidance for the 2020 plan year. This includes draft qualified health plan (QHP) application templates and final rate filing deadlines, as well as detail on the CSR reconciliation process for 2018.

From Health Affairs:

CMS will go forward with CSR reconciliation for 2018 even though the Trump administration opted to end CSR payments to insurers in October 2017. This is because of ongoing litigation where at least six insurers—in front of three different judges in the Court of Federal Claims—sued successfully for unpaid CSRs.

The federal government disputed this amount and asked for a delay in final judgment until after the CSR reconciliation process for 2018 is completed. The court agreed with the government that final judgment could wait until after the 2018 reconciliation process. The court reached the same conclusion in a lawsuit brought by Maine Community Health Options; the same dispute is playing out in a separate lawsuit brought by L.A. Care Health Plan.


About L.A. Care Health Plan

L.A. Care Health Plan serves nearly 2.2 million members in Los Angeles County, making it the largest publicly-operated health plan in the country. L.A. Care offers four health coverage plans including Medi-CalL.A. Care Covered™L.A. Care Cal MediConnect Plan and the PASC-SEIU Homecare Workers Health Care Plan, all dedicated to being accountable and responsive to members. As a public entity, L.A. Care’s mission is to provide access to quality health care for L.A. County's low-income communities, and to support the safety net required to achieve that purpose. L.A. Care prioritizes quality, access and inclusion, elevating health care for all of L.A. County. For more information, follow us on TwitterFacebookLinkedIn, and Instagram.

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