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.
Officials developed the rule, which will start to apply July 1, to implement a provision of the Patient Protection and Affordable Care Act of 2010 (PPACA).
PPACA opponents are fighting the act in Congress and at the Supreme Court.
Today, the minimum MLR requirements in the law require affected health coverage issuers to spend at least 85% of large group revenue and 80% of individual and small group revenue on health care and quality improvement efforts. Issuers that miss the PPACA minimum MLR targets will have to pay rebates.
In December 2011, CMS — an arm of the U.S. Department of Health and Human Services (HHS) — published a final rule explaining how the issuers that will have to pay rebates must meet their notice requirements.
CMS officials asked for comments about how they should handle issuers that will not have to pay rebates.
CMS received 56 public comments on the final rule and 11 more comments on a paperwork reduction notice posted in February.
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.