|
Member log-in |
About us
Membership
Code of Conduct
Newsroom
Publications
Issues
Governance Review Initiative
Strategic Planning Committee
Academy Board Election Center
Calendar of events
Jobs
TRACE
ASB
ABCD
Public discipline
Profession-wide search
Find an actuary
Links
With the enactment of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act, which made a number of adjustments to PPACA, attention now shifts to the implementation phase of health care reform. The Academy's Health Practice Council has established a number of work groups charged with providing input on implementation of a variety of provisions in the new law. Actuaries bring a unique perspective that is crucial to the development of workable health care reform regulation. On this page, you will find links to HPC comment letters related to the various provisions included in PPACA, as well as other resources related to the new law and its implementation. Please bookmark this page and check back with us frequently. As implementation proceeds, we'll be updating and adding information regularly. The Academy's Critical Issues in Health Reform series and other documents related to the health care reform dialogue can still be found on the Health Reform Now page.
Actuarial Value Newly Released DocumentsLetter to HHS on research brief addressing actuarial valueThe Health Practice Council sent a letter to the Assistant Secretary for Planning and Evaluation (ASPE) at HHS providing comments on a recently released research brief, Actuarial Value and Employer-Sponsored Insurance. (01/31/12) Letter to HHS on Essential Health Benefits BulletinThe Individual and Small Group Market Task Force provided comments to HHS on its December 2011 bulletin addressing essential health benefits. (01/31/12) Letter to Mass. Senate on amendment to H.3535The Premium Review Work Group sent a letter to the Mass. Senate regarding an amendment to the state budget that would require the disapproval of any health insurance rates to be “supported by sound actuarial assumptions and methods.” (11/1/11) Comments to CMS on risk-sharing mechanisms proposed ruleThe Risk Sharing Work Group submitted comments to CMS in response to the proposed rule implementing risk adjustment, reinsurance, and risk corridors under the ACA. (10/28/11) Comments to CMS on Exchanges proposed ruleThe Academy submitted comments to CMS in response to proposed regulations establishing health insurance exchanges and qualified health plans under the ACA. (10/06/11) Letter on NAIC on MedSupp white paperThe Academy recently sent a letter to the NAIC Medigap PPACA Subgroup offering comments on the subgroup’s new discussion paper, Medicare Supplement Insurance First Dollar Coverage and Cost-Shares. (10/04/11) Letter on Medicare to Joint Select Committee on Deficit ReductionThe Academy recently sent a comment letter to the members of the new Joint Select Committee on Deficit Reduction urging action to improve the long-term solvency and sustainability of the Medicare program. (8/31/11) Actuarial Value issue brief releasedThe Academy released a new issue brief, Actuarial Value under the Affordable Care Act. The brief offers an overview of the concept of actuarial value and provides insight into the calculation of actuarial value under ACA. (07/21/11) Written Testimony on 2011 Medicare Trustees ReportThe Academy submits written testimony to the House Ways and Means Subcommittee on Health regarding a hearing on the 2011 Medicare Trustees Report (07/05/11) Letter to CMS on Rate Review and Disclosure FormsThe Academy submits comments to CMS in response to the revised preliminary justification and consumer disclosure forms for purposes of rate review disclosure and reporting requirements (06/28/11) ACO issue brief releasedThe Academy released a new issue brief, An Actuarial Perspective on Accountable Care Organizations. The brief provides an actuarial overview of ACOs and outlines a number of issues that stakeholders should evaluate as ACOs are implemented. (06/16/11) Risk-Sharing under ACA issue brief releasedThe Academy released a new issue brief, Risk Adjustment and Other Risk-Sharing Provisions in the Affordable Care Act. The brief provides an overview of the various risk-sharing mechanisms in ACA and the risks each mechanism can mitigate. (06/09/11) Comments to CMS on ACO proposed regulationThe Academy submits comments to CMS in response to proposed regulations on accountable care organizations and the Medicare Shared Savings Program under ACA. (06/06/11) Issue brief on the 2011 Medicare Trustees ReportThe Academy's Medicare Steering Committee released a new issue brief that highlights the 2011 Medicare Trustees Report and outlines the public policy options to address Social Security's long-term financial soundness. (05/25/11) Issue brief on Proposals to Improve Medicare's Financial ConditionThe Medicare Steering Committee released a new issue brief that summarizes the key cost, access, and quality issues associated with some of the Medicare-related provisions in the various debt and deficit reduction proposals. (05/11/11) Letter to CMS on Rate Review and Disclosure FormsThe Academy submits comments to CMS in response to a notice on rate increase disclosure and review reporting requirements. (5/2/11) Letter to NAIC on Adverse Selection White PaperThe Academy submits comments to the NAIC Exchanges (B) Subgroup regarding its white paper on adverse selection. (04/05/11) Letter to HHS on CO-OPsThe Academy writes a letter to HHS in response to its request for comments on the consumer operated and oriented plan programs. (3/4/11) Comments to HHS on rate review proposed regulationsThe Academy submits comments to HHS in response to proposed regulations on rate increase disclosure and review. (2/22/11) Comments to HHS re: MLR interim final ruleThe Academy writes a letter to HHS in response to an interim final rule on the medical loss ratio provisions in ACA. (1/31/11) Comments to NAIC re: rate filing disclosure formThe Academy writes a comment letter on the NAIC B Committee's exposure draft of a rate filing disclosure form that is intended to facilitate the reporting of unreasonable rate increases to HHS.
Actuarial ValueLetter to HHS on research brief addressing actuarial valueThe Health Practice Council sent a letter to the Assistant Secretary for Planning and Evaluation (ASPE) at HHS providing comments on a recently released research brief, Actuarial Value and Employer-Sponsored Insurance. (01/31/12) Actuarial Value issue brief releasedThe Academy released a new issue brief, Actuarial Value under the Affordable Care Act. The brief offers an overview of the concept of actuarial value and provides insight into the calculation of actuarial value under ACA. (07/21/11)
Essential Health BenefitsLetter to HHS on Essential Health Benefits BulletinThe Individual and Small Group Market Task Force provided comments to HHS on its December 2011 bulletin addressing essential health benefits. (01/31/12)
Risk Adjustment, Reinsurance and Risk CorridorsComments to CMS on risk-sharing mechanisms proposed ruleThe Risk Sharing Work Group submitted comments to CMS in response to the proposed rule implementing risk adjustment, reinsurance, and risk corridors under the ACA. (10/28/11) Risk-Sharing under ACA issue brief releasedThe Academy released a new issue brief, Risk Adjustment and Other Risk-Sharing Provisions in the Affordable Care Act. The brief provides an overview of the various risk-sharing mechanisms in ACA and the risks each mechanism can mitigate. (06/09/11) Letter to HHS on Reinsurance ProvisionThe Academy writes a letter to HHS attached regarding the ACA reinsurance provision that references the Academy. The letter includes initial input on potential approaches for identifying high-risk individuals and determining reinsurance payments. (09/22/10) Risk Adjustment issue brief releasedThe Academy Health Practice Council released a new issue brief, Risk Assessment and Risk Adjustment. The brief provides an overview of risk adjustment and outlines general considerations for implementing a risk adjustment mechanism under PPACA.
Medical Loss Ratio Reporting and RebatesComments to HHS re: MLR interim final ruleThe Academy writes a letter to HHS in response to an interim final rule on the medical loss ratio provisions in ACA. (1/31/11) Comments to HHS re: NAIC MLR proposed regulationThe Academy writes a letter to HHS, addressing three components of the NAIC's proposed regulation on medical loss ratios: credibility adjustments, exclusion of federal taxes from the denominator, and the use of three months' runout. Letter to NAIC on draft MLR rebate regulationThe Academy writes a letter to the chair of the NAIC B Committee regarding the October 4 exposure draft of the proposed MLR rebate regulation. (10/13/10) Letter to HHS on MLR credibilityThe Academy provides input to HHS on credibility issues for the purpose of calculating rebates under the new MLR requirements. Letter to NAIC on Contract ReservesThe Academy writes a letter to the chair of the NAICs Accident and Health Working Group offering input on the potential inclusion of a change in contract reserves in the numerator of the MLR rebate calculation. Letter to the NAIC on Supplemental Health Care Exhibit exposure draftThe Academy writes a letter to the chair of the NAIC's Health Care Reform Solvency Impact Subgroup on an exposure draft of a new proposed financial reporting exhibit the Supplemental Health Care Exhibit. Letter to HHS regarding MLR provisionsThe Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that requires medical loss ratio reporting and rebates. Letter to the NAIC regarding statistical credibilityThe Academy writes a letter to the chair of the NAIC's Accident and Health Working Group responding to his request for input on defining an appropriate way to maintain statistical validity within the rebate process. The Academy sent a subsequent letter to respond to a request from the NAIC for more information on statistical credibility. Letter to the NAIC regarding MLR considerations and potential disruption in the individual marketThe Academy writes a second letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding the medical loss ratio provisions and the potential for individual market disruption under the Patient Protection and Affordability Act. Letter to the NAIC regarding medical loss ratio provisions in health reform lawThe Academy writes a letter to the Chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding considerations related to the Patient Protection and Affordability Act Medical Loss Ratio Provisions (2718).
Premium ReviewLetter to Mass. Senate on amendment to H.3535The Premium Review Work Group sent a letter to the Mass. Senate regarding an amendment to the state budget that would require the disapproval of any health insurance rates to be “supported by sound actuarial assumptions and methods.” (11/1/11) Letter to CMS on Rate Review and Disclosure FormsThe Academy submits comments to CMS in response to the revised preliminary justification and consumer disclosure forms for purposes of rate review disclosure and reporting requirements (06/28/11) Letter to CMS on Rate Review and Disclosure FormsThe Academy submits comments to CMS in response to a notice on rate increase disclosure and review reporting requirements. (5/2/11) Comments to HHS on rate review proposed regulationsThe Academy submits comments to HHS in response to proposed regulations on rate increase disclosure and review. (2/22/11) Comments to NAIC re: rate filing disclosure formThe Academy writes a comment letter on the NAIC B Committee's exposure draft of a rate filing disclosure form that is intended to facilitate the reporting of unreasonable rate increases to HHS. Comments to HHS re: defining "unreasonable" rate increasesThe Academy writes a letter to HHS providing an evaluation of several potential methods for defining or measuring "unreasonable" rate increases. (10/29/10) Letter to Mass. legislature on SB 2447The Academy writes a letter regarding Massachusetts Senate Bill 2447, which includes a provision that would limit rate increases to medical CPI. Letter to the NAIC on draft rate-filing disclosure formThe Academy writes a comment letter on the NAIC's exposure draft of a rate-filing disclosure form that is intended to facilitate the reporting of unreasonable rate increases to HHS. Letter to HHS regarding rate reviewThe Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that establishes a review process for unreasonable rate increases. Letter to the NAIC regarding premium reviewThe Academy writes a letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup, the Accident and Health Working Group, and the Rate Review Subgroup regarding the Patient Protection and Affordability Act (PPACA) provision that establishes a review process for unreasonable rate increases.
Consumer Operated and Oriented Plan Programs (CO-OPs)Letter to HHS on CO-OPsThe Academy writes a letter to HHS in response to its request for comments on the consumer operated and oriented plan programs. (03/04/11)
Early Retiree Reinsurance ProgramLetter to HHS on Early Retiree ReinsuranceThe Academy writes a letter to the Department of Health and Human Services in response to an interim final rule on the PPACA provision that creates a temporary reinsurance program for early retirees.
ExchangesComments to CMS on Exchanges proposed ruleThe Academy submitted comments to CMS in response to proposed regulations establishing health insurance exchanges and qualified health plans under the ACA. (10/06/11) Letter to HHS on ExchangesThe Academy writes a letter to HHS in response to its request for comments on the exchange-related provisions in ACA. (10/05/10)
Near-term Benefit and Eligibility ChangesLetter to HHS on Preventive ServicesThe Academy writes a letter to HHS in response to an interim final rule on first-dollar coverage of preventive services. (09/22/10) Letter to HHS on Annual/Lifetime Limits and Pre-ExThe Academy writes a letter to HHS in response to an interim final rule on ACA provisions that eliminate lifetime limits, restrict annual limits, eliminate preexisting condition exclusions, and prohibit rescissions. Letter to HHS on dependent coverageThe Academy writes a letter to HHS in response to an interim final rule on the PPACA provision that extends dependent coverage to age 26.
Grandfathering ProvisionsLetter to HHS on grandfathered coverageThe Academy writes a letter to HHS in response to an interim final rule on the ACA provision related to the status of health insurance coverage as a grandfathered plan.
Accountable Care Organizations (ACOs)Fact sheet on Medicare Shared Savings Program and ACOs under the Affordable Care ActThe Academy released a new fact sheet that provides an overview of the Medicare Shared Savings Program and how ACOs are addressed in the Affordable Care Act. (06/16/11) ACO issue brief releasedThe Academy released a new issue brief, An Actuarial Perspective on Accountable Care Organizations. The brief provides an actuarial overview of ACOs and outlines a number of issues that stakeholders should evaluate as ACOs are implemented. (06/16/11) Comments to CMS on ACO proposed regulationThe Academy submits comments to CMS in response to proposed regulations on accountable care organizations and the Medicare Shared Savings Program under ACA. (06/06/11)
OtherLetter on NAIC on MedSupp white paperThe Academy recently sent a letter to the NAIC Medigap PPACA Subgroup offering comments on the subgroup’s new discussion paper, Medicare Supplement Insurance First Dollar Coverage and Cost-Shares. (10/04/11) Letter to NAIC on Adverse Selection White PaperThe Academy submits comments to the NAIC Exchanges (B) Subgroup regarding its white paper on adverse selection. (04/05/11) Health Reform GlossaryHealth Reform Implementation: Understanding the Terminology Presentation to NCOIL on the CLASS ActSteven Schoonveld presents during the July 11 National Conference of Insurance Legislators (NCOIL) Summer Meeting. His presentation focused on educating lawmakers about the CLASS Act (the new voluntary, long-term care services program). Presentation on Health Reform ImplementationAcademy Senior Health Fellow Cori Uccello presents during a June 15 American Enterprise Institute event, offering an actuarial perspective on health care reform implementation.
MedicareLetter on Medicare to Joint Select Committee on Deficit ReductionThe Academy recently sent a comment letter to the members of the new Joint Select Committee on Deficit Reduction urging action to improve the long-term solvency and sustainability of the Medicare program. (8/31/11) Written Testimony on 2011 Medicare Trustees ReportThe Academy submits written testimony to the House Ways and Means Subcommittee on Health regarding a hearing on the 2011 Medicare Trustees Report (07/05/11) Issue brief on the 2011 Medicare Trustees ReportThe Academy's Medicare Steering Committee released a new issue brief that highlights the 2011 Medicare Trustees Report and outlines the public policy options to address Social Security's long-term financial soundness. (05/25/11) Issue brief on Proposals to Improve Medicare's Financial ConditionThe Medicare Steering Committee released a new issue brief that summarizes the key cost, access, and quality issues associated with some of the Medicare-related provisions in the various debt and deficit reduction proposals. (05/11/11)
|
|
|
Related links:
External links:
