Collection and distribution of unpaid 2022 benefit year risk adjustment charges
This document describes CMS actions to collect unpaid 2022 benefit year risk adjustment charges from two issuers (Bright Health Group and Friday Health Plans), the use of repayment agreements, debt collection remedies, and effects on distribution of 2022 risk adjustment payments to other issuers in impacted state market risk pools.
CMS will use all appropriate federal debt collection processes to enforce collection of unpaid 2022 benefit year risk adjustment charges and may accept repayment plans under 45 C.F.R. § 30.17.
CMS approved four 18-month repayment agreements with Bright, structured with interest-only monthly payments and a balloon payment at the end of the term.
Friday Health Plans entered state liquidations and has paid only 5% of its $780 million 2022 risk adjustment charges; CMS will pursue federal debt collection including offsets and filing proofs of claim.
Collection and Distribution Rules for 2022 Risk Adjustment Charges
Collection and distribution criteria for unpaid 2022 risk adjustment charges
Stance on collection and distribution of 2022 benefit year risk adjustment payments in affected market risk pools.
Collection methods
- CMS will use all appropriate Federal debt collection processes, including offsetting other ACA program payments pursuant to 45 C.F.R. § 156.1215 and filing proofs of claim to assert the government's claim to debts owed.
- If an issuer misses payments or fails to pay principal by the end of an approved repayment agreement, CMS will refer the debts to the U.S. Treasury for collection.
Repayment agreements
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