Maine Community Health Options v. United States

OPINION

BRUGGINK, Judge.

This is a claim for statutory entitlement to payment under the “Risk Corridors Program” (“RCP”) created by section 1342 of the Affordable Care Act (“ACA”), codified at 42 U.S.C. § 18062 (2012) (“section 1342”). The RCP is in essence a program in which insurers, and potentially the government, share both the risk and reward inherent in setting plan premiums. Plaintiff, Maine Community Health Options (“CHO”) is a nonprofit corporation with its principal place of business in Lewiston, Maine. It provides health insurance to its members under the federally-facilitated market…