Policy and Legislation
This whole medical loss ratio (MLR) provision in the new health care law is a fool’s errand. When it comes to controlling health care costs it is about as productive as taking your shoes off at the airport is valuable at improving air travel security.
In yet another good news/bad news scenario, lawmakers once again postponed a 23 percent reduction in Medicare reimbursements to doctors - but only for one month.
Health and Human Services Secretary Kathleen Sebelius has launched the new application cycle for the National Health Service Corps Loan Repayment Program, which received $290 million from the Affordable Care Act this year.
New regulations issued by the Department of Health and Human Services require health insurers to spend 80 percent to 85 percent of consumers' premiums on direct care for patients and efforts to improve care quality, starting in 2011.
The Medical Loss Ratio requirements contained in the Patient Protection and Affordable Care Act take effect on January 1, 2011. Even though the Department of Health and Human Services has yet to certify the recommendation concerning how carriers should calculate the percentage of premium they pay toward medical care and health quality measures, the carriers have to be managing their businesses to hit the MLR targets on January 1st.
Connolly Healthcare, the Recovery Audit Contractor (RAC) for 17 states, posted 35 new issues and removed four older issues on its "approved issues" Web page last week. The postings continued a pattern of confusing and incomplete information that healthcare providers have come to expect from the four RACs during recent months.
State governments, like California's, that are already well into the efforts involved in establishing insurance exchanges meeting ACA requirements, may be starting to worry after the mid-term election results.
A national physicians organization says doctors are unhappy with healthcare reform and feel that patient care will suffer as a consequence.
The average per capita cost of healthcare services covered by commercial insurance and Medicare rose 7.08 percent over the past 12 months, according to data released this week by Standard & Poor's.
The 2010 Commonwealth Fund International Health Policy Survey finds the US lags behind other rich countries in health care system performance.