Community Health Choice prevailed in a lawsuit alleging the federal government owed them for unpaid cost-sharing reduction (CSR) payments. Our firm represented the health insurer, arguing that the federal government violated 42 U.S. Code § 18071, an Affordable Care Act (ACA) provision designed to compensate insurers for the cost of reducing the deductibles and co-pays of policyholders whose household income was below 250% of the poverty line.
The U.S. Federal Court of Claims determined that the federal government violated a money-mandating statute and breached an implied-in-fact contract and that Community Health Choice was entitled to $71.5 million in back payments.
