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Text of CMS Announcement: Cost-Sharing Reduction Amounts in Risk Corridors and Medical Loss Ratio Reporting (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] [Official Guidance] June 22, 2015
"As a result of the new timetable for CSR reconciliation, the actual value of CSRs provided by the issuer will not be available in time for risk corridors and medical loss ratio (MLR) program reporting for the 2014 benefit year. Therefore, for the purpose of adjusting allowable costs in the risk corridors calculation and incurred claims in the MLR calculation for the 2014 benefit year, issuers should use the amount of the CSR portion of the advance payments received by the issuer for 2014 ... [To] ensure the integrity of data used in risk corridors and MLR calculations, we intend to propose a policy in the HHS Notice of Benefit and Payment Parameters for 2017 under which CMS would implement an adjustment to the risk corridors and MLR calculations for 2015 to correct for any inaccuracies in the estimated CSR provided in 2014 that were reported in the 2014 risk corridors and MLR reporting form." [Unnumbered document, June 19, 2015]
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