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Health Insurers Gird for MLR Changes



New rules require health plans to apply between 80% and 85% of premiums directly to patient care or quality improvement initiatives. Payers that don't comply with federally mandated medical loss ratios will be forced to provide rebates to their customers. Now the quibbling over how to calculate payments begins.



2 comments on "Health Insurers Gird for MLR Changes"
Chloe (12/29/2010 at 8:43 PM)

Hello?!!! Where have you been Barium?? Doctors have been living with far worse than anything health plans face, for years. Try being told how much you can charge, who you can charge, what services you can offer, where you can offer them, AND live under the constant threat that you might inadvertently neglect to collect a co-pay on grandma, and be subject to criminal sanctions. Tough isn't it?
barium (12/2/2010 at 10:56 AM)

Hello? Do we realize what is happening here? How would American businesspeople react if THEY were told their businesses would be audited by the federal government, and that they would be required by law to refund to their clients any revenue over a 20% administrative expense? And if they exceeded 20% in any product line and lost money, oh, well, I guess that's tough. What? Here we are, frogs sitting in a pot of cold water on the stove, falling asleep until we become froglegs. Does anyone else out there recognize the dangerous precedent being set here? What are we going to do about it?