Overnight Healthcare: Medicaid proposal draws fire from insurers
The Hill
Overnight Healthcare: Medicaid proposal draws fire from insurers
The federal government on Tuesday unveiled a long-awaited regulatory package that sets national standards for Medicaid managed care and introduces the unpopular "medical loss ratio" into the program.
The nearly 700-page rule, described by some groups as an "uber rule," contains instructions about what state Medicaid programs must do when hiring private health plans to handle long-term care for the elderly and disabled also known as managed care.
One of the biggest proposed changes has already been introduced to government health programs via ObamaCare the medical loss ratio.
The medical loss ratio, also known as MLR, sets the minimum amount of all premium dollars that are directly spent on healthcare. The policy, widely despised by insurers, is intended to cut overhead spending.
The proposed rule from CMS would set the medical loss ratio at 85 percent, which it described as the "industry standard" for large employers in the private health insurance market.
Jeff Myers, the president and CEO of Medicaid Health Plans, said he had "strongly encouraged CMS not to go down this route" because he said every state has already implemented some form of the medical loss ratio.
Myers, who had a dozen people still combing through the rules Tuesday evening, warned that the proposed rules could "destabilize the programs that are developed on a state level."
The Centers for Medicare and Medicare Services (CMS) is also proposing that Medicaid managed care groups align their standards with those in the private marketplace to create more uniform practices across states.
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