The Trump administration won’t penalize insurers for failing to verify the number of severely ill patients they’ve enrolled through the insurance exchanges. The Affordable Care Act mandated that third-party auditors and the Department of Health and Human Services validate that plans receiving risk-adjustment payments do indeed have sicker patients. However, HHS has struggled to get the program off the ground due, in part, to technical woes. Although HHS has been collecting audit data from the plans, it hasn’t held them accountable for discrepancies in their sick patient volumes.
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