MODA HEALTH PLAN, INC. v. U.S.

2017-1994.

892 F.3d 1311 (2018)

MODA HEALTH PLAN, INC., Plaintiff-Appellee v. UNITED STATES, Defendant-Appellant.

United States Court of Appeals, Federal Circuit.

Decided: June 14, 2018.


Attorney(s) appearing for the Case

STEVEN ROSENBAUM , Covington & Burling LLP, Washington, DC, argued for plaintiff-appellee. Also represented by SHRUTI CHAGANTI BARKER , CAROLINE BROWN , PHILIP PEISCH .

ALISA BETH KLEIN , Appellate Staff, Civil Division, United States Department of Justice, Washington, DC, argued for defendant-appellant. Also represented by CHAD A. READLER , MARK B. STERN .

THOMAS G. HUNGAR , Office of General Counsel, United States House of Representatives, Washington, DC, for amicus curiae United States House of Representatives. Also represented by KIMBERLY HAMM , TODD B. TATELMAN .

WILLIAM LEWIS ROBERTS , Faegre Baker Daniels LLP, Minneapolis, MN, for amicus curiae Association for Community Affiliated Plans. Also represented by JONATHAN WILLIAM DETTMANN , KELLY J. FERMOYLE , NICHOLAS JAMES NELSON .

STEVEN ALLEN NEELEY, JR. , Husch Blackwell LLP, Washington, DC, for amicus curiae National Association of Insurance Commissioners.

STEPHEN A. SWEDLOW , Quinn Emanuel Urquhart & Sullivan, LLP, Chicago, IL, for amicus curiae Health Republic Insurance Company.

URSULA TAYLOR , Butler Rubin Saltarelli & Boyd LLP, Chicago, IL, for amicus curiae Blue Cross Blue Shield Association. Also represented by SANDRA J. DURKIN .

BENJAMIN N. GUTMAN , Oregon Department of Justice, Salem, OR, for amici curiae State of Oregon, State of Alaska, State of Connecticut, State of Hawaii, State of Illinois, State of Iowa, State of Maryland, State of Massachusetts, State of Minnesota, State of New Mexico, State of North Carolina, State of Pennsylvania, State of Rhode Island, State of Vermont, State of Virginia, State of Washington, State of Wyoming, District of Columbia.

Dissenting opinion filed by Circuit Judge Newman.


A health insurer contends that the government failed to satisfy the full amount of its payment obligation under a program designed to alleviate the risk of offering coverage to an expanded pool of individuals. The Court of Federal Claims entered judgment for the insurer on both statutory and contract grounds. The government appeals...

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