Loyola primary care physicians honored with Blue Ribbon rating from Blue Cross and Blue Shield

April 08, 2017

In other health reform policy news, Maine has asked the federal government to exempt it temporarily from adhering to health reform law rules governing medical-loss ratios, saying it could force one of the state's health plans out of business in the state, according to The Wall Street Journal, in a separate story. "At issue are tougher rules governing the so-called medical-loss ratio, a measure of how much insurers spend on medical care compared with their administrative expenses and profits. Under the new law, insurers must pay out at least 80% of the premiums collected from individuals on medical care. Regulators at the National Association of Insurance Commissioners are drafting rules to determine what insurers can count as medical expenses and what protections might help smaller plans stay afloat." Maine's insurance superintendent said the rule, if implemented too quickly, could force HealthMarkets Inc. to stop doing business in the state, leaving just WellPoint's Anthem Blue Cross & Blue Shield the sole option for consumers. "The law allows HHS to grant exemptions if the requirement will upend markets. HHS has received the letter, which is the first from a state regulator, and it will be establishing the process for reviewing such requests in regulations that it plans to issue, said an HHS spokeswoman" (Johnson, 7/14).

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