Tuesday, August 24, 2010

MLR redux

The August 29th, 2009 blog entry, 'Health care re-form VIII (More nonsense)', discussed the medical loss ratio in some detail, how it is being 'misused', and also touched upon some of the demagoguery surrounding this subject...

Fast forward a year - health care reform legislation has passed and minimums have been set for insurance company MLRs (80 percent for individual and small business plans, 85% for large employers). Of course, having read the earlier blog entry the reader knows there is no standard definition and a lot of "wiggle room" in the calculation of MLR. Thus it has become necessary to develop a standard definition and calculation methodology.

Meeting in Seattle, the National Association of Insurance Commissioners' (NAIC) Executive Committee has developed a recommendation (see suggested template) that is being forwarded to Health and Human Services Secretary Kathleen Sibelius. The recommendations in theory should form the basis for regulations that will be issued by HHS. However, Democratic legislators, advocacy groups, and other will no doubt be soon weighing in, see 'Sebelius could face health-reg fight'. Let the simplification and demagoguery begin!

Transcript: Health On The Hill - August 16, 2010

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