So Your Premium Dollars Go the Patient Care…

The MLR regs are out!

The U.S. Department of Health and Human Services today released regulations to make sure our premium dollars go to patient care, rather than administration and profit. These rules on “medical loss ratios” are a key piece of the new federal health law, and they go into effect January 2011. That’s why the National Association of Insurance Commissioners were so busy this past year in crafting the regulation–and why our colleague Beth Abbott, who serves as a NAIC consumer representative, was on so many conference calls in these negotiations with literally hundreds of insurance industry lobbyists. Insurers tried to define “patient care” broadly, and argue for several loopholes, and we are glad that HHS rebuffed most of those attempts.

In general, the new MLR rule is a commonsense and fair regulation, providing important new protections and choices to consumers and levels the playing field for insurers. The industry now has clear goals that responsible companies can achieve, and if insurance companies don’t comply they’ll have to pay rebates to their customers.

We’ll have more analysis soon, but it’s a big step…

Health Access California promotes quality, affordable health care for all Californians.

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