House Republicans Pressure HHS on MLR

“We have also heard testimony regarding the negative impacts of the MLR provision on patient choice in health coverage, as well as its deleterious effects on health care quality and the prevent of fraud,” the congressmen said in the letter.

The letter asked if HHS officials had discussed the MLR regulation with commissioners or staff, and wanted to know which staffers and commissioners participated in such discussions.

The letter also asks whether HHS officials engaged in any communications “with you or any NAIC staff, whether oral or written, which indicated that HHS would refuse to certify in whole or in part the model regulations being considered by the NAIC?”

The letter also asks whether HHS officials provided NAIC commissioners or staff with legal interpretations of activities that may or may not be included within the definition of “activities that improve health care quality,” and “non-claim costs” under provisions of the regulations under attack by the committee.

The committee has introduced two measures supported by the insurance agents. But the panel appears to be unable to win full committee and full House support for the measures. And, Democrats in the Senate are opposed, according to industry officials, as are insurance commissioners in large states, such as California, Washington and New York.

One is H.R. 1206, which would exclude producer compensation from medical loss ratio calculations. Another is H.R. 2077, which would repeal the MLR entirely.

H.R. 1206, sponsored by Rep. Mike Rogers, R-Mich., and John Barrow, D-Ga., has strong support. The bill has 139 co-sponsors. But it has been mired for months in the House.

The Independent Insurance Agents and Brokers of America, the National Association of Health Underwriters and the National Association of Insurance and Financial Advisors have voiced deep concern about including agent commissions in the MLR, and its impact on jobs and revenues in the agent community.

In the latest comment, Leonard Brevik executive vice president of the National Association of Professional Insurance Agents, said he was ”disappointed” with the NAIC decision.

 “Our members who sell health insurance want to continue doing so, but HHS doesn’t seem to value the participation of producers. As a result, Congress must act.”

Brevik said that Congress mandated in the healthcare law that agents and brokers be full participants under the new healthcare law, but “HHS is trying to undo that provision through the regulatory process.”