In This Issue:

- Top News

..CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors

..Early State Filings Show Premium Reductions under ACA

..HHS Received More Than 830 Letters of Intent for Navigator Program

..Hearing Highlights Divergent Positions on ACA’s Impact on Rates, Consumers

..House Subcommittee Chair Says New Draft of Physician Pay Fix Week of May 27

..Federal Prosecutors Get Guilty Pleas from Three Clinical Laboratory Executives in Anti-Kickback Cases

- State News

..Ninth Circuit Declares Arizona Abortion Law Unconstitutional

..States Face Technical Challenges Developing Health Insurance Exchanges

..Patient Record Breach at Idaho University Clinics Leads to Settlement, Corrective Action

..California Exchange Unveils Plans with Moderate Premium Rates

..Minnesota Ranked Best State For Seniors

..Mississippi Governor Gives $1M to Health Law Call Center

- Medicare

..Senators Ask GAO to Investigate Online Information From Medicare Rx Plans

- Regulatory News

..HHS Reduces Medicare Payment Rates for Pre-Existing Condition Insurance Program

..CMS Offers Options to State to Aid Enrollment Under Medicaid Expansion

..Medicare Benefit Package Should Only Be Altered Within Larger Reform Context

..Final Rule Upholds Increased Rewards, Penalties For Wellness Participation

..Medicare Costs May Keep Declining

..Health Law Is Fostering Competition, US Says

- Additional Reading

- Federal Register

- For More Information

- Excerpt from CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors:

On May 23, the Centers for Medicare and Medicaid Services (CMS) finalized the requirement under the Affordable Care Act (ACA) that Medicare Advantage and Part D drug sponsors devote 85% of their revenue to clinical services, prescription drugs, and other enrollee benefits. This percentage, known as the medical loss ratio (MLR), represents the percentage of revenue that must be used for patient care, rather than administrative expenses or profits. The final rule (CMS-4173- F) can be found here. Although industry representatives urged CMS not to apply the MLR rule to the Part D drug program, citing a lack of clear Congressional intent to do so, CMS maintained that the ACA requires application of the MLR rule to the Part D program.

Please see full Newsletter below for more information.

LOADING PDF: If there are any problems, click here to download the file.

Written by:

Published In:

CMS
FDA
HHS

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Polsinelli | Attorney Advertising

Don't miss a thing! Build a custom news brief:

Read fresh new writing on compliance, cybersecurity, Dodd-Frank, whistleblowers, social media, hiring & firing, patent reform, the NLRB, Obamacare, the SEC…

…or whatever matters the most to you. Follow authors, firms, and topics on JD Supra.

Create your news brief now - it's free and easy »

All the intelligence you need, in one easy email:

Great! Your first step to building an email digest of JD Supra authors and topics. Log in with LinkedIn so we can start sending your digest...

Sign up for your custom alerts now, using LinkedIn ›

* With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name.
×
Loading...
×
×