Health Insurer Risk Adjustment Ruling Not Appealable, Court Says

The Fifth Circuit said it couldn’t hear a Texas health insurer’s appeal in a case over federal rules aimed at spreading the cost of insuring sicker patients among health plans.

The lower court decision at issue wasn’t a final ruling subject to appeal because the district court remanded one of the insurer’s claims to the Department of Health and Human Services, the U.S. Court of Appeals for the Fifth Circuit said Wednesday.

The case involved the federal risk adjustment program, in which fees are assessed against health plans with healthier-than-average enrollees in a given state, and payments are made to ...