Academy Activities

The Academy and the Society of Actuaries jointly sponsored a webinar series on recently released Affordable Care Act (ACA) regulations. During three 90-minute webinars, representatives from the Center for Consumer Information and Insurance Oversight provided an overview of health insurance market reforms (Dec. 10), the three risk-sharing programs (Dec. 13), and essential health benefits and actuarial value (Dec. 14). Each of the webinars, which were moderated by Academy Senior Health Fellow Cori Uccello, attracted more than 800 participants.

Legislative and Regulatory Updates

The Department of Health and Human Services on Nov. 30 released a proposed rule that clarifies several key provisions in the ACA. The rule:

• Provides greater detail on payment methodologies and data collection for risk adjustment, risk corridors, and reinsurance programs;
• Addresses how to account for risk adjustment, risk corridors, and reinsurance programs in the current medical loss ratio calculation (MLR) and the timing for MLR reporting and rebates;
• Provides more information on the administration of advance payments for premium tax credits and cost-sharing reductions;
• Clarifies Small Business Health Options Program (SHOP)-related standards that were created in the final rule on the implementation of exchanges.

Comments are due by Dec. 31.

The Office of Personnel Management (OPM) on Dec. 5 issued a proposed rule implementing the Multi-State Plan Program (MSPP), a component of the ACA. The MSPP will consist of two multi-state plans that will be offered by health insurance issuers through contracts with the OPM and made available through each of the available exchanges. The OPM said the rule was developed with input from a broad array of stakeholders and it plans to administer the MSPP in a manner consistent with state insurance laws. Comments are due by Jan. 4, 2013.

In The News/Media Activities

California Insurance Commissioner Dave Jones cited the Academy’s Medicaid decision brief in a Dec. 9 San Francisco Chronicle opinion piece on Medi-Cal expansion.

The Academy was mentioned in Health Affairs Blog, “Implementing Health Reform: Essential Health Benefits, Actuarial Value, And Accreditation.”

News links are to external websites. The Academy is not responsible for the content of these websites.

Upcoming Health Care Reform Events

National Health Policy Conference
Conference: Feb. 4–5, Washington (fee charged)
Sponsor: AcademyHealth

For a complete listing of upcoming and recent health care reform events click here.