Filed Under:Markets, Employee Benefits

PPACA MLR Rules: What If the Insurer Paid Enough Claims?

Even issuers that hit the new PPACA MLR targets will have to send rebate notices this year. (AP Photo/Carolyn Kaster)
Even issuers that hit the new PPACA MLR targets will have to send rebate notices this year. (AP Photo/Carolyn Kaster)

The Centers for Medicare & Medicaid Services (CMS) is trying to lighten the new medical loss ratio (MLR) rebate notice rules, officials say.

CMS officials have outlined new MLR rebate notice rules in a final rule set to appear in the Federal Register Wednesday.

Consumer groups told CMS they thought expanding notice requirements would give consumers important information. The groups asked CMS to require issuers to send notices that include their 2010 and 2011 MLR figures.

Health insurers and an employer group noted that the PPACA MLR rules only started to take effect in 2011, that comparisons with the 2010 MLR figures could be misleading, and that another part of PPACA already will require HHS to publish issuers' MLR data on the Web.

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Nichole Morford

Nichole Morford
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