Insurers who do not verify the number of severely ill patients enrolled through the exchanges will not be penalized. The ACA mandated that health plans that receive risk-adjustment payments prove they enroll sicker patients. According to ACHP President and CEO Ceci Connolly, companies do not yet have federal data on the accuracy of their claims, so it is too soon to report on lessons learned.
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The Alliance of Community Health Plans is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. Our plans are shaping the future of health care - driving better health outcomes, building healthier communities and inspiring an entire industry to do better.