Risk adjustment update

In Mayhew On Insurance by David Anderson

The Office of Management and Budget (OMB) received an interim final rule from Health and Human Services (HHS) regarding the retrospective justification of the risk adjustment process in the ACA:



This is good news.

I have not been too worried about the risk adjustment suspension. My concern-o-meter had been at 3% for the past two weeks. Everyone who I have talked to who is clued in with CMS has said that the risk adjustment hold was highly likely to be temporary and it was the results of internal idiosyncratic processes and not deliberate policy to mess up the market.

The easiest solution to the entire mess would be for an interim final rule to be issued that basically copies and pastes the NBPP2019 risk adjustment language for previous years. That is what looks like is happening.