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."
Insights
Client Alert | 9 min read | 07.09.25
In our first alert in our new weekly series on the EU Pharma Package, we provided some important background and general information about the status of the Pharma Package and how the trilogues work. In this second alert, we will discuss the respective positions of the European Commission, the European Parliament and the Council of the European Union with respect to one of the most debated and anxiously anticipated topics on the table, the regulatory data protection (RDP).
Client Alert | 3 min read | 07.08.25
Client Alert | 3 min read | 07.08.25
DOJ and HHS Launch FCA Working Group: Heightened Enforcement Risk for Health Care Entities
Client Alert | 5 min read | 07.08.25
