We have worked with our partners at UBA to provide you with the latest Health Care Reform Update:
Technical Guidance Issued Regarding Medical Loss Ratio Requirements
On May 13, 2011, HHS issued a bulletin which provided technical guidance regarding Medical Loss Ratio requirements for insurers.
This Bulletin contains seventeen Q&As on the following topics regarding the MLR Interim Final Rule:
• Definition of Small Employer;
• Mini-Med Plan MLR Reporting;
• Expatriate Plan MLR Reporting;
• Reimbursement for Clinical Services Provided to Enrollees (Incurred Claims);
• Third-Party Vendor Payments;
• Activities that Improve Health Care Quality; and
• A State Request for Adjustment to the MLR Standard.
The entire text can be found HERE.
HHS Issues Final Rules On Health Insurance Rate Reviews
Under new rules issued by the Obama Administration, health insurers will be "required to justify annual premium increases of 10 percent or more to state regulators." The regulations were contained in a 94-page document released on May 19.
"Starting in September 2012, the federal government will set a separate threshold for each state, reflecting trends in insurance and health care costs." Federal officials "acknowledged that they did not have the authority to block rates that were found to be unjustified," but they noted that many states already have that authority.
Moreover, the federal government is "providing $250 million to states to strengthen their capacity," although a few states opposed to the federal health care law "have turned down the money."
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