Court of Federal Claims Grants Summary Judgment on $214 Million ACA "Risk Corridors" Claim
Client Alert | 1 min read | 02.10.17
In Moda Health Plan, Inc. v. U.S. (Feb. 9, 2017), the Court of Federal Claims granted summary judgment in favor of a health insurer in a lawsuit seeking to recover "risk corridors" payments pursuant to §1342 of the Affordable Care Act, deciding on the merits that (i) the plaintiff was entitled to full payments owed to it under the statutory formula set forth in the ACA, (ii) Congress did not intend the risk corridors program to be budget-neutral, and (iii) later appropriations bills restricting HHS' access to the CMS Program Management Account for risk corridors payments did not repeal or amend this obligation to make full annual payments. In an important decision likely to reverberate throughout the individual insurance market, the Court stated that "the Government made a promise in the risk corridors program that it has yet to fill … [and] the Court directs the Government to fulfill that promise."
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Client Alert | 7 min read | 01.30.26
CMS Proposes CY 2027 Growth Rate and Changes to Risk Adjustment for Medicare Parts C and D
On January 26, 2026, the Centers for Medicare and Medicaid Services (CMS) circulated the Calendar Year (CY) 2027 Advance Notice to communicate proposed changes to Medicare Advantage (MA) capitation rates and Parts C and D payment policies. The changes are expected to be finalized in April 2026 but may be delayed. The following is a summary of the most significant proposals, with further details below:
Client Alert | 4 min read | 01.30.26
Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
Client Alert | 9 min read | 01.30.26
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ASEAN Digital Ministers' Meeting 2026: Spotlight on AI Cooperation in Asia's Rising Markets
