government
House panel endorses health reform, Medicare bills
NEWS IN BRIEF — Posted Oct. 8, 2012
The House Energy and Commerce Committee approved several health policy bills before Congress recessed until after the 2012 presidential election, one of which addresses the calculation of the Affordable Care Act’s minimum medical-loss ratio requirement.
The medical-loss ratio formula stipulates that insurers must spend at least 80% or 85% of premium dollars on actual medical care or quality improvements, as opposed to administrative or overhead expenses, which include agents’ and brokers’ fees. Those that don’t meet the minimum must pay rebates to customers the following year.
On Sept. 20, the House panel approved legislation sponsored by Rep. Mike Rogers (R, Mich.) that would exclude fees for insurance agents and brokers from the calculation. Counting these fees as an administrative expenses could affect the insurance market adversely, forcing agents to leave or reduce their plan offerings, making it more challenging for patients to find affordable care, according to a statement from the committee. The bill was approved by a vote of 26-14.
The panel by voice vote approved another bill by Rep. Tim Murphy (R, Pa.) that seeks to remove bureaucratic delays from the Medicare Secondary Payer statute, which determines when a payer other than Medicare is responsible for covering an elderly person’s medical bills.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2012/10/08/gvbf1008.htm.
