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New York Issues Emergency Regulation to Address Impact of Federal Risk Adjustment Program on New York Health Insurers
Department of Financial Services [DFS], New York State
[Guidance Overview] Sept. 12, 2016
"Under the new regulation, after CMS makes its 2017 risk adjustment program calculations, [the Department of Financial Services (DFS)] will determine if the CMS calculations will have an adverse impact on New York's small group health insurance marketplace. If there is an adverse impact, the Superintendent will implement a 'market stabilization pool' taking into account certain factors relevant to the New York market. Utilizing these additional factors, insurers who received money from the risk adjustment program will pay an allocable percentage of that money into a fund administered by DFS. DFS will then transfer that money to those insurers who paid into the risk adjustment program and were adversely impacted."
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