Academy Activities

The Academy’s Medical Loss Ratio (MLR) Regulation Work Group sent a letter on May 20 to the National Association of Insurance Commissioners (NAIC) on statistical credibility related to MLR rebate calculations under Section 2718 of the Public Health Service Act, which was created by the passage of the Patient Protection and Affordable Care Act. This letter was issued in response to a request from the NAIC for additional information based on the group’s initial May 12 letter. The first letter presented two illustrative tables of potential credibility adjustments. The most recent letter expanded upon its use of confidence intervals and provided corresponding tables for different confidence interval choices.

The MLR Work Group also submitted a comment letter on May 17 to the NAIC on its exposure draft of a new proposed financial reporting exhibit, the Supplemental Health Care Exhibit.

New Volunteer Opportunity: The Academy is currently seeking volunteers for the recently formed Joint Academy/SOA Cancer Claim Cost Tables Work Group, which has been tasked with updating and evaluating the 1985 Cancer Claim Cost Tables. If you are interested in joining this new work group, please contact Timothy Mahony, Academy state health policy analyst, at 202-785-7880 or Mahony@actuary.org.

Legislative Updates

The House took up on Friday a revised version of a “tax extenders” bill (H.R. 4213) on the floor that would postpone scheduled cuts in Medicare payments to doctors through 2011, instead increasing Medicare physician reimbursements from current levels by 2.2 percent for the remainder of 2010 and by 1 percent in 2011. Since the Senate has already adjourned for the Memorial Day recess, the Senate will resume work on the House’s revisions to the bill that were made on Friday. A 21.3 percent physician payment cut is scheduled to take effect June 1.

In the News

Academy Senior Health Fellow Cori Uccello discussed the impact of bringing young people into the health care market—one of the most vital components of health care reform—in the May 13 edition of the Bend, Ore., Bulletin. Uccello said that young people, on average, have lower medical spending costs and carry lower risks than older people. She said that the new health care reform law brings in young people, which helps achieve a broad cross-section of risk and stabilizes the risk pool over time.

The Academy MLR Work Group’s April 28 letter to the NAIC regarding the potential disruption to the individual health insurance market as a result of new MLR requirements was cited in the NAIC’s report to the U.S. Department of Health and Human Services. As reported by the Bureau of National Affairs on May 24, the NAIC cited scenarios described by the Academy in which inappropriate requirements could disrupt the individual market prior to 2014 when more sweeping market reforms take effect.

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