The federal government may administer the reinsurance program for the states, or states may choose to administer their own reinsurance plan. If states choose to run their own program, there is no formal Department of Health and Human Services (HHS) approval process. However, federal guidelines must be followed 2. Contributions are collected by the HHS and states must follow a national payment schedule, but are allowed to collect additional funds if they deem necessary 2. According to the Kaiser Family Foundation, the HHS sets the contribution rate per year that must be collected from all individual, small, and large group market insurers, as well as self-funded plans. Funds are collected from all health insurance issuers and third party administrators then the HHS distributes the payments based on need. The reinsurance payments are only given to individual market plans on the exchange that are subject to new ...
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...MS should put proper measures in place to correctly assess the amount of contributions for that year. The Center for Medicare and Medicaid Services could face criminal charges for unauthorized spending of government funds 4.
One of the obvious solutions would have the insurers give the money back to the United States Treasury Department. The insurers may have to return a total of 2.74 billion dollars back to the federal government 4. The GAO believes that the money should be paid pro rata by year in relation to how much money insurers received in 2014 and 2015. 4. Insurance companies would face major losses if mandated to return a percent of the money they received from the federal government. One of the key stakeholders is the administration leading the ACA because many insurance companies do not have an incentive to stay in the market exchanges due to the losses.
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