Health Insurance Reform Weekly Medical cost trends for 2012

May 27th, 2011 charmy

Health Insurance Reform Weekly Medical cost trends for 2012

Health Insurance Reform Weekly Medical cost trends for 2012

Free Online Articles Directory

Why Submit Articles?
Top Authors
Top Articles
FAQ
ABAnswers

Publish Article

0 && $ .browser.msie ) {
var ie_version = parseInt($ .browser.version);
if(ie_version Login

Login via

Register
Hello
My Home
Sign Out

Email

Password


Remember me?
Lost Password?

Home Page > Finance > Insurance > Health Insurance Reform Weekly Medical cost trends for 2012

Categories
AdvertisingArts & EntertainmentAutomotiveBeautyBusinessCareersComputersEducationFinanceFood and BeverageHealthHobbiesHome and FamilyHome ImprovementInternetLawMarketingNews and SocietyRelationshipsSelf ImprovementShoppingSpiritualitySports and FitnessTechnologyTravelWriting

]]>

Health Insurance Reform Weekly Medical cost trends for 2012

By: Health Insurance
Posted: May 26, 2011

PricewaterhouseCoopers and Medco Health Solutions released two new views of cost trends in health care during the past week, building on the release of the Milliman Medical Index.   PwC Health Research Institute’s “Behind the numbers: Medical cost trends for 2012,” examines the medical cost trends for employers in 2012.  This new report found “Medical cost trend is expected to increase from 8 percent in 2011 to 8.5 percent in 2012.”  And two main drivers identified by PwC are provider consolidation and cost-shifting to the private sector.

Providing a view of prescription drug utilization and pricing trends, Medco’s Annual Drug Trend Report showed this week that while the overall growth of prescription drug prices is at an historic low (as a result of increased use of generic drugs), the cost of specialty treatments is still increasing at an alarming rate.  According to Medco’s report “Specialty drug trend was 17.4 percent in 2010, fueled by unit cost growth of 11.5 percent.”

Federal

There is no Federal report for this week.

States

ARIZONA: The Department of Insurance (DOI) held a public hearing on rate review as part of its Health and Human Services (HHS) grant activities. The DOI has retained Mercer Consulting to assist in performing a gap analysis to identify areas that need to be addressed in order to comply with the requirements of the Affordable Care Act (ACA). During the hearing, it was noted that the state’s current statutory scheme does not authorize the DOI to review a health insurer’s medical loss ratio, potentially not allowing the state to meet the HHS requirement of having “an effective rate review process.”

The Director of Insurance and the Governor’s office also hosted their first workgroup on the implementation of an exchange. Despite the legislature’s refusal to pass an exchange bill, there is concern at the executive level about a lack of preparedness in the event the ACA is not repealed or found unconstitutional. This week’s topic was the qualified health plan certification, and participants focused on not adding requirements beyond the ACA minimum benefit requirements.

CALIFORNIA: The Appropriations committees of both houses are wading through many bills that would have varying impacts on state finances.  Bills meeting certain dollar thresholds are sent to “suspense” filing for consideration at later hearings.  Most of the legislation that Aetna and other allies have opposed has been sent to the “suspense” filing, including a bill on rate regulation and all bills on benefit mandates, because of the fiscal impact of each bill and potential conflicts with federal guidance on essential benefits. These bills may be revived at a later date, or they may be held by the committees.  We expect the majority of the bills to be voted off the suspense file by the end of the month, including.

Rate regulation – According to Appropriations, there would be an annual fee-supported special fund cost of at least million to DMHC and CDI.
Rate regulation – According to Appropriations, there would be an annual fee-supported special fund cost of at least million to DMHC and CDI.
Autism mandate – According to the committee analysis, this bill would result in annual costs to the following state entities:
CalPERS: million
Medi-Cal, for enrollees in managed care plans: 4 million
MRMIB plans (Healthy Families, AIM, MRMIP): million

In state budget news, the governor will release his May revision to the state budget next week, taking into account new revenue figures that show the state taking in more than billion in unanticipated new tax dollars. The governor still believes that asking voters to extend the higher tax rates set to expire this summer is the right thing to do because the higher revenue forecasts would not close the entire budget shortfall.  Republicans, however, have been quick to argue that higher revenue forecasts mean that extending tax rates is not needed at this time.

CONNECTICUT: The legislative session adjourns June 8, but the legislature has yet to reach a conclusion on several major issues, including an exchange bill, a rate review bill and the SustiNet bill.  Although the SustiNet compromise bill language is not public, the Administration and press reports have said that the bill does not include a public option but would create an advisory board on health reform implementation and examination of future state reforms. In addition, an anti-most favored nation clause bill has passed the House and now goes to the Senate for its consideration. Aetna supported the bill with amendments. The bill is expected to pass. Additionally, the recently released HHS rate review rule may push legislators to advocate for adoption of the federal 10 percent trigger for rate review in Connecticut, just in case the federal law is repealed.

DELAWARE: The Department of Insurance (DOI) submitted a medical loss ratio (MLR) waiver application to HHS for its individual health insurance market. The DOI-requested adjustment proposes a three-year phase-in of the MLR as follows: 65 percent for 2011, 70 percent for 2012, and 75 percent for 2013.

GEORGIA:  Governor Deal has signed legislation that applies state prompt-pay standards to self-funded plans.  Aetna will be working with self-funded customers who have questions about the validity of the new law and its application to their plans, which are generally covered by ERISA.

]]>

INDIANA: Insurance Commissioner Stephen Robertson submitted an MLR waiver request to HHS seeking relief from the MLR regulation for the individual market and for consumer-directed health plans in both the individual and small group markets.  Specifically, for the individual market, Indiana is requesting that the MLR be waived for the individual market through 2014, or, as an alternative, that it be phased in as follows: 65 percent in 2011, 68.75 percent in 2012, 72.5 percent in 2013, 76.25 percent in 2014, and 80 percent in 2015, with an exemption from the MLR requirement until 2014 for new market entrants (defined as those that have not previously sold individual major medical health insurance products in Indiana for the previous 10-year period). For consumer-directed health plans in the individual and small group markets, Indiana is requesting a permanent waiver from the federal MLR requirements.

MAINE: Governor LePage has signed into law an Act to Modify Rating Practices for Individual and Small Group Health Plans. The new law is designed to open up Maine’s individual and small-group insurance market to competition. It also is supposed to:

help lower health insurance premiums by broadening Maine’s community rating system and allowing insurance companies to base their premiums on a more flexible set of criteria.
allow Maine residents to purchase insurance in four New England states beginning in 2014.
set up a reinsurance pool to cover individuals with serious illnesses. The pool would be subsidized by a covered lives assessment capped at per member per month.

The Maine People’s Alliance (a progressive advocacy group), the Maine Democratic Party, and others are looking into the feasibility of initiating a referendum on the new law. In order to get a referendum on the November ballot, opponents would have to file approximately 60,000 signatures with the secretary of state no later than 90 days after the enactment of the bill on May 17, 2011.

MONTANA: Governor Brian Schweitzer has decided to reconsider his amendatory veto of legislation that prohibits the state from enforcing the individual responsibility requirement contained in the ACA.  Noting the critical role that the individual mandate plays in lowering the cost of coverage, the Governor’s amendatory veto argued that the prohibition against enforcing the mandate in Montana should be contingent on whether residents have access to affordable coverage.  However, on May 13, the Governor reversed his position and signed the bill into law, as permitted under Montana’s statutory procedural guidelines.  The provisions of the law include

Incoming search terms:

Pages: 1 2 3

Posted in Heathly Trim Articles Tags: , , , , , , ,
«
»
You can leave a response, or trackback from your own site.

Leave a Reply

Twitter Delicious Facebook Digg Stumbleupon Favorites More