Insurance pre­mium rate hikes 10% or more now re­quire re­view

Modern Healthcare - - Late News -

In­sur­ers that want to raise pre­mium rates by 10% or more must now sub­mit pro­pos­als to state or fed­eral re­view­ers, who will de­ter­mine if the hikes are rea­son­able. Un­der a re­quire­ment of the health­care re­form law, in­de­pen­dent ex­perts will com­pare the re­quests against un­der­ly­ing cost trends in health­care. Con­sumers in ev­ery state will be able to view and com­ment on in­for­ma­tion ex­plain­ing in­creases of 10% or more—com­pared with last year’s rates—be­gin­ning in mid-Septem­ber. HHS says fund­ing from the Pa­tient Pro­tec­tion and Af­ford­able Care Act helped Mary­land re­duce pre­mium in­creases in 10 of the 22 rate fil­ings ap­proved dur­ing the third quar­ter of last year, while Rhode Is­land low­ered a 20% in­crease to 10% last month. Fed­eral grant fund­ing, HHS said, has al­lowed states to hire more staff for rate re­views; in­vest in needed in­for­ma­tion tech­nol­ogy; and im­prove fil­ing re­quire­ments. The in­dus­try’s largest trade group doubts the re­views will have much ef­fect. “Pre­mium costs are a re­flec­tion of the un­der­ly­ing cost of med­i­cal care in a lo­cal mar­ket,” Amer­ica’s Health Insurance Plans wrote in a blog post last week. “Highly pub­li­cized pro­vi­sions such as pre­mium rate re­view make for good sound bites but lit­er­ally do noth­ing to address the soar­ing cost of med­i­cal care.”

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