During a joint session today, the Executive and Plenary committees of the National Association of Insurance Commissioners (NAIC) voted to adopt a model regulation containing the definitions and methodologies for calculating medical loss ratios as required by the Patient Protection and Affordable Care Act (PPACA). The model will be delivered to federal Health and Human Services for certification by Secretary Sebelius.
The PPACA requires that beginning in 2011, insurance companies meet new medical loss ratio requires designed to ensure premium dollars go to health care. The law requires that the NAIC provide recommendations for the definitions and calculations of these ratios to HHS by December 31, 2001.
For additional background, READ Focus on Health System Reform—The Medical Loss Ratio, (Bulletin, June 4, 2010).