FACT CHECK: What You Need to Know about MLR
Posted by The Campaign on July 22, 2010 at 6:15 AM
Medical Loss Ratio – What You Need to Know
A new AHIP document outlines four key goals the MLR requirement should address to help minimize disruption and preserve patients access to high-quality health care services:
· Ensure that existing efforts to improve quality are allowed to continue and new initiatives to support the goals of PPACA are not discouraged;
· Recognize that quality improvement efforts will be advanced by ICD-10 implementation;
· Include fraud prevention and detection activities in the definition of activities that improve health care quality; and
· Implement a plan for transitioning from the existing state system to the new federal standards to maximize consumer choice.
What They Are Saying - Medical Loss Ratio
(includes comments from health care quality groups, the American Academy of Actuaries, and national employer organizations)
What They Are Saying – State Employer Groups on the Medical Loss Ratio Definition
(includes comments from state-based business groups)
Letter from the Maine insurance commissioner requesting a waiver from the new MLR requirement. According to the letter: "Absent a waiver, I believe that the federal MLR standard may disrupt our individual health insurance market."
The FACTS About Health Plan Administrative Costs
