If you offered Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2019 benefit year, made cost-sharing reductions for eligible insureds pursuant to Section 1402 of the Patient Protection and Affordable Care Act, and you did not receive a “timely and periodic” payment from the Government of an amount “equal to the value of the reductions” provided to your insureds, you may opt-in to join a lawsuit.

What is this lawsuit about?

Plaintiff Common Ground Healthcare Cooperative claims that Defendant United States has not made cost-sharing reduction payments on a timely and periodic basis for the 2019 benefit year to which it and other QHP issuers are entitled under the Affordable Care Act. Beginning in 2014, the United States began making these cost-sharing reduction payments, but then ceased paying them in 2017 and continues to not pay them.

In March 2019, Plaintiff Common Ground Healthcare Cooperative amended a previously filed class action lawsuit in the United States Court of Federal Claims to add a claim alleging that the Government violated Section 1402 of the Affordable Care Act and its implementing regulations by failing to make “periodic and timely” cost-sharing reduction payments for the 2019 benefit year.  Plaintiff claims that the Class is entitled to relief under the Tucker Act, a federal statute that provides the United States Court of Federal Claims with jurisdiction to award money judgments against the federal government where a statute is money-mandating and requires payment.  The case was assigned to Judge Margaret M. Sweeney.  On May 29, 2020, the Court entered an order granting class certification and appointing Quinn Emanuel Urquhart & Sullivan, LLP as lead counsel for the Class.  

Who is a potential Class Member?

Under the Rules of the United States Court of Federal Claims, the Court has allowed the lawsuit to be a class action on behalf of the following class of people or entities: 

All persons or entities offering Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2019 benefit year, and who made cost-sharing reductions for eligible insureds pursuant to Section 1402 of the Patient Protection and Affordable Care Act, but did not receive a “timely and periodic” payment from the Government of an amount “equal to the value of the reductions” provided to its insureds.  Excluded from the Class is the Defendant and its members, agencies, divisions, departments, and employees.

You will need to decide whether you wish to join this lawsuit as a Class Member.  You are not part of the Class unless and until you fill out the Class Action Opt-In Notice Form, which can be submitted here. This “opt in” procedure is different than many other class action lawsuits in the United States because, if do you do nothing, you will not be able to participate in the lawsuit as a Class Member.