Insurance regulators are wrestling with questions about the definitions they should use when implementing the new Affordable Care Act minimum medical loss ratio rules.
Consumer representatives have told the Patient Protection and Affordable Care Act actuarial subgroup, an arm of the Accident and Health Working Group at the National Association of Insurance Commissioners, Kansas City, Mo., that regulators should be strict about keeping health insurers from putting costs that may not do much to help patients in the medical cost category.
Health insurance company executives say regulators should let insurers put a wide range of wellness, condition management and patient education expenses in the medical cost category.
ACA is the legislative package that includes PPACA and the Health Care and Education Reconciliation Act.
The Accident and Health Working Group is developing a response to a request for minimum MLR information recently issued by officials at the U.S. Department of Health and Human Services, the U.S. Labor Department and the U.S. Treasury Department.