Text of CMS Final Regs: AdoptIon of the Methodology for the HHS-Operated Permanent Risk Adjustment Program for the 2017 Benefit Year (PDF)

18 pages. "This final rule adopts the risk adjustment methodology that HHS previously established for the 2017 benefit year.... In February 2018, a district court vacated the use of state wide average premium as a basis for the HHS-operated risk adjustment methodology for the 2014, 2015, 2016, 2017, and 2018 benefit years ... Absent this administrative action, HHS would be unable in the coming months to collect charges or make payments to issuers for the 2017 benefit year. These amounts total billions of dollars, and failure to make the payments in a timely manner threatens to undermine the stability of the insurance markets ... [CMS] hereby adopt[s] the rules set out in the publication in the Federal Register on March 23, 2012 and the publication in the Federal Register on March 8, 2016 ."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

CMS Adopts Methodology for the Permanent Risk Adjustment Program for the 2017 Benefit Year

"A hearing on the motion for reconsideration was held on June 21, 2018 in which the judge suggested a final ruling may not come until Labor Day.... This circumstance provided good cause for CMS to issue a final rule that dispenses with the typical notice and comment period. This final rule provides a fuller explanation supporting the 2017 risk adjustment methodology, consistent with the judge's request, and allows us to resume the risk adjustment program without delay.... [The] final rule announces the agency's intention to issue a Notice of Proposed Rulemaking (NPRM) to propose and solicit comment on the CMS risk adjustment methodology that will apply to the 2018 benefit year, which was also vacated by the court." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]