5/3/2012
Senators Seek Input from Health Care Community on Fraud and Abuse Prevention
Yesterday six Senators from the Senate Finance Committee released an open letter to the health care community requesting a "fresh perspective" regarding fraud and abuse in Medicare and Medicaid. The letter requests input from a variety of stakeholders in the health care community, including providers, payers, health plans, contractors, non-profit entities, consumers, data analytics entities, governmental partners and patients. With stakeholder input, the Senators hope to “identify innovative solutions th... (Read More)
5/1/2012
HHS Releases Guidance on Medical Loss Ratio Requirements
The Department of Health and Human Services (HHS) recently issued technical guidance regarding medical loss ratio (MLR) requirements in the form of a questions and answers bulletin issued by the Office of Oversight.
The MLR requires health insurers to submit reports to the HHS Secretary and spend 80% or 85% of all premium dollars on medical care or activities that improve health care quality or provide rebates to customers. The final rule implementing the MRL requirements was published in December 201... (Read More)
4/26/2012
Medicare Board of Trustees Report Trust Exhaustion in 2024
Earlier this week, the Board of Trustees for Medicare and Social Security released its 2012 annual report. The report noted that the Medicare trust fund is not adequately financed over the next ten years, and without changes to current law, the fund will be insolvent as of 2024. The insolvency date did not change from the estimated date reported in the Board’s 2011 annual report due, in part, to cuts in provider payments and lower than anticipated expenditures in 2011.
The report provides a summary of... (Read More)