Sioux Falls, S.D.-based Sanford Health Plan filed a lawsuit against the federal government seeking $9 million in risk corridors payments, The Bismarck Tribune reports.
The ACA's risk corridors program aimed to level the financial playing field for payers taking on newly insured, costlier patients. Between 2014 and 2016, insurers paid into the program if their premiums exceeded claims and other costs by a set amount. That money was then issued back to payers whose claims surpassed premiums by a certain amount, effectively evening the risk of covering the newly insured.
However, Congress did not fund the program as stated in the law, according to the report.
"Despite these express and binding obligations, the risk corridors program — like the ACA as a whole — has been the target of subsequent Congressional actions designed to impede [the government's] ability to administer the program as mandated by the ACA," Sanford said in its lawsuit, according to The Bismarck Tribune. The suit was filed in the U.S. Court of Claims in Washington, D.C.
Sanford said it is owed $9 million for losses it accrued through selling coverage in North Dakota, South Dakota and Iowa, the report states.