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Healthcare › Medical Loss Ratio

Nossaman LLP

CA DHCS Announces New MLR Requirements on Subcontractors, Including IPAs, RBOs and RKKs

Nossaman LLP on

California’s Department of Health Care Services (DHCS) is in the final stages of establishing new Medical Loss Ratio (MLR) requirements in Medi-Cal Managed Care. Most significantly, the guidelines specify that the MLR...more

Manatt, Phelps & Phillips, LLP

CMS Proposes Changes to Medicare Advantage and Part D Programs

Manatt, Phelps & Phillips, LLP on

On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule,...more

Manatt, Phelps & Phillips, LLP

CMS Releases Proposed 2023 Notice of Benefit and Payment Parameters

Manatt, Phelps & Phillips, LLP on

In December 2021, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters for 2023. This proposal kicks off the annual rulemaking cycle for the Marketplaces and the...more

Sheppard Mullin Richter & Hampton LLP

Day One Notes for the 40th Annual J.P. Morgan Healthcare Conference, 2022

Sheppard Mullin Richter & Hampton LLP on

For those of you who know me, I like to have fun with my Zoom backgrounds – choosing photos of interesting scenery or changing them mid-call to reflect my mood or negotiating strategy. Sitting in front of my computer this...more

Alston & Bird

A&B Healthcare Week In Review, September 2015

Alston & Bird on

On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more

McDermott Will & Emery

Medicaid Managed Care Update: CMS Proposes Broad-Reaching Reforms to Modernize Medicaid Managed Care

McDermott Will & Emery on

The proposals strive to balance increased federal government oversight and administration with continued recognition of, and flexibility for, state managed care programs. This is the first article in a series that takes...more

Proskauer - Employee Benefits & Executive...

Year Two of Medical Loss Ratio Rebates: Five Tips for Insured ERISA Health Plan Sponsors

Proskauer - Employee Benefits & Executive... on

The Affordable Care Act’s medical loss ratio (“MLR”) rule requires health insurance companies (but not self-insured plans) in the group or individual market to provide an annual rebate to enrollees if the insurer’s MLR falls...more

Polsinelli

Health Reform + Related Health Policy News - May 2013

Polsinelli on

In This Issue: - Top News ..Tavenner Wins Senate Confirmation to Head CMS ..US Charges 89 in Nationwide Medicare Fraud Crackdown - State News ..Vermont Becomes Fourth State to Allow Physician-Assisted...more

Mintz - Health Care Viewpoints

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

Mintz - Health Care Viewpoints on

Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. ...more

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