CMS to conduct insurance rate reviews for 10 states beginning Sept. 1

Healthcare Finance News, July 11, 2011

The Centers for Medicare & Medicaid Services released a report showing that 10 states lack sufficient authority under current law to review and reject excessive health insurance rate increases as required under the Affordable Care Act. Beginning Sept. 1 CMS will begin review of all rate hikes in excess of 10% for these states. The Department of Health and Human Services announced the new regulation—which covers only individual and small group policies—in May and set the threshold for review at 10% and will be in effect for one year. In 2012 states will be expected to set their own rate increase thresholds as they see fit based on market conditions in each state. "Effective rate review works—it does so by protecting consumers from unreasonable rate increases and bringing needed transparency to the marketplace," said HHS Secretary Kathleen Sebelius in May when the regulation was announced. "During the past year we have worked closely with states to strengthen their ability to review, revise or reject unreasonable rate hikes. This final rule helps build on that partnership to protect consumers."

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