Blue Cross of Idaho has filed a $79.3 million claim against the federal government.
The health insurer says it is owed the money under the Affordable Care Act “risk corridors” program, according to a complaint filed Monday in the U.S. Court of Federal Claims.
The risk corridors program, a temporary three-year program effective 2014 through 2016, is designed to help insurers ease into the new health care marketplace and stabilize premiums.
Under the program, the federal government collects money from qualified insurers whose premiums exceed claims costs by a certain amount and makes payments to qualified insurers whose claims costs exceed premiums collected by a certain amount.
Blue Cross of Idaho says in its complaint that the federal government has “arbitrarily” paid it less than 13 percent of the total amount due in 2014 and it will not make any payments to Blue Cross in 2015, which is a breach of contract.
The Department of Justice on Sept. 30 asked the Court of Federal Claims to dismiss two similar risk-corridor lawsuits filed by Blue Cross and Blue Shield of North Carolina, and Portland, Ore.-based Moda Health Plan. The department said the payments are not due until the end of the three-year period, and the amounts due have yet to be determined.
Blue Cross and Blue Shield of North Carolina says it is owed $147.5 million. Moda Health Plan says it is owed $180 million.