In the last day of the legislative session last Saturday, the Massachusetts state legislature passed a bill aimed at reigning in health insurance costs and enhancing small businesses' health insurance purchasing power. Health insurers will now be required to spend at least 88 percent of the premiums they collect on services directly tied to medical care and quality improvement activities. The New York state legislature passed a similar bill in June requiring health insurers to spend 82% of premium dollars on medical care. Federal regulators are expected to release in the coming weeks their definition of what activities can and cannot be counted towards the medical loss ratio (MLR) calculation. Health plans, employer groups and other business advocates are advocating for federal regulators to include wellness and disease management programs, among other things, in the numerator.
The bill also includes a provision that will now allow Massachusetts small businesses to enhance their health insurance purchasing power by forming purchasing cooperatives. Businesses with fewer than 50 employees will be able to band together to exert greater purchasing clout and insurers will be required to offer plans that include low-cost providers in their networks. To combat consumers signing up for health insurance only right when they actually need medical services, the bill also allows insurers to restrict plan enrollment to only two open enrollment periods in 2011 and one in years thereafter.
Click here to read more.
No comments:
Post a Comment