MLR Waiver Bill Would Shift Power to States
A key waiver provision of the Patient Protection and Affordable Care Act would be amended under a medical loss ratio (MLR) bill scheduled for mark-up Thursday before the House Energy and Commerce Committee.
That provision of HR 1206 would give states the final say on MLR waiver requests. MLR waiver authority now rests with the Centers for Medicare & Medicaid Services.
The ACA requires insurers to spend no more than 20% of premium payments collected for the individual and small group market on administrative expenses such as salaries, overhead, and markets. The remainder, up to 80% of premium dollars, must be spent on direct patient care and efforts to improve care quality.
Insurers that fail to meet that standard are required to make financial rebates to their members.
This year insurers rebated $1.1 billion to 12.8 million members.
- Antibiotic Overuse a 'Huge Threat' to Patient Safety, Says CDC
- CFO Exchange: Smartphones Poised to Disrupt Healthcare, Says Topol
- Consumerism Drives Healthcare Branding, Rebranding Efforts
- 3 Traits Personality Assessments Can't Reveal
- PA Ranks See 'Phenomenal Growth,' Lack of Diversity
- CHS Hacked, 4.5M Patient Records Compromised
- Business Roundup: M&A Activity Down Slightly in First Half of 2014
- CFO Exchange: Healthcare Leaders Share 5 Innovative Ideas
- CNO on Hospital Redesign: 'You Can't Over-Communicate'
- Large Employers Trimming Healthcare Spending