Saturday, March 26, 2011

Misc update (MLR)

The last blog entry in February noted that there was still lots of activity swirling around the definitions and calculations of the Medical Loss Ratio, capped by the Patient Protection and Affordable Care Act (PPACA) at 80% (small groups) and 85% (large groups)... The MLR calculations promulgated by the U.S. Dept. of Health and Human Services (HHS) included the fees paid to insurance agents and brokers in administrative expenses, while the National Association of Insurance Commissioners (NAIC) proposed that they be counted toward care dollars. Industry groups are fighting to have commissions treated as a pass-through expense, as commissions are being reduced. Democratic legislators and liberal groups are dead set against any such change....

Meanwhile HHS granted the State of Maine a three-year 'hardship' waiver from the MLR rules... "... Three other states (Kentucky, New Hampshire, and Nevada) have already filed waiver requests with HHS, and an additional eleven states are reported to be preparing waiver requests..." (see here)

Medical loss ratio issues still up for grabs
Senate Dem opposes brokers' MLR bill
Maine Waiver Expected To Increase Insurer Pressures on States

Some previous blog entries referencing the MLR:
Misc update - V - Feb 13th, 2011
Misc updates - MLR - Oct 25th, 2010
MLR Redux - Aug 24th, 2010
MLR update - Jun 27th, 2010
Health care re-form VIII (More nonsense) - August 28th, 2009

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