Risk adjustment update

The Office of Management and Budget (OMB) received an interim final rule from Health and Human Services (HHS) regarding the retrospective justification of the risk adjustment process in the ACA:

 

 

This is good news.

I have not been too worried about the risk adjustment suspension. My concern-o-meter had been at 3% for the past two weeks. Everyone who I have talked to who is clued in with CMS has said that the risk adjustment hold was highly likely to be temporary and it was the results of internal idiosyncratic processes and not deliberate policy to mess up the market.

The easiest solution to the entire mess would be for an interim final rule to be issued that basically copies and pastes the NBPP2019 risk adjustment language for previous years. That is what looks like is happening.






2 replies
  1. 1
    Julia Grey says:

    That IS good news.

  2. 2
    Aardvark Cheeselog says:

    “Interim final rule?”

    It seems like there can be interim rules, and there can be final rules, but how can an interim rule be a final rule?

    They should steal a term from software development, where (when we think we’re getting close) we have “release candidate” versions. “Proposed final rule” would be better. Even though there are probably already such things as “proposed rules.”

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