On August 10, 2020, Humana sued the federal Department of Health and Human Services (HHS) to recover cost sharing reduction payments related to Qualified Health Plans (QHP) offered through the Patient Protection and Affordable Care Act (PPACA) health insurance exchanges. The cost sharing reduction payments are subsidies paid to reduce out-of-pocket costs for low-income consumers who purchase silver-level QHPs through the Health Insurance Marketplace.
HHS ended the CSR payments on October 12, 2017, after a legal opinion determined that Congress needed to appropriate the funds in order for the CSR funds to be disbursed. HHS said the CSR payments were prohibited unless and until a valid appropriation exists. The federal Department of Justice later dropped its argument that a Congressional appropriation was needed.
In the lawsuit, Humana said it participated in the Health Insurance Marketplace in 2017 with the understanding that HHS would pay the CSRs. After HHS eliminated the payments, Humana was not able to change its QHP premiums or the footprint of its plans.
Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. As of 2014, Humana had over 13 million members in the U.S.
This was reported by Fierce Healthcare on August 11, 2020.
Contact information: Kelley Murphy, Corporate Communications, Humana Inc., 500 West Main Street, Louisville, Kentucky 40202; 502-224-1755; Email: Kmurphy26@humana.com; Website: https://humana.gcs-web.com/
