The Department of Health and Human Services announced Monday it has issued long-awaited regulations on the medical loss ratio provision of the Affordable Care Act.
New rules require health insurers to spend 80 percent (for individual and small-group markets) to 85 percent (for large group contracts) of consumers' premiums on direct care for patients and efforts to improve care quality. If they do not meet this requirement, they have to issue rebates to policyholders, beginning in 2012.
The interim final regs issued by HHS were, for the most part, not changed from those recommended by the National Association of Insurance Commissioners in late October. The Department announced it has also incorporated recommendations from a letter sent from the NAIC to HHS Secretary Kathleen Sebelius on Oct. 13 [See related: "NAIC updates Sebelius on MLR issues"]
Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.
Your access to unlimited BenefitsPRO content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
