This should come as no surprise as insurers have to investigate fully and take advantage of all their business intelligence software for guidance here as this will impact investor relations and the what they can predict to shareholders in the way of dividends. Perhaps the HHS requirements here didn’t allow for this. I would think that those with experience with working with health insurers would be fully aware of how this process works. We read about Blue Cross in the news recently changing their accounting assignments to place more into the “service” and “claim” areas than what they had deemed appropriate in the past – they need time to run those cost algorithms. United Healthcare is right on top of this and notified shareholders that their dividends would be paid more frequently so you can see this takes time and of course they also did not want to lose investors with all of this being in the news.
UnitedHealth To Pay Out Higher and More Frequent Dividends to Share Holders, No Caps on Earnings for Executives or What Is Spent on Lobbying Says the Board
We also had Blue Cross in the news of late adjusting their algorithms to determine how they could work their numbers and could some premium payments possibly go towards VC ventures.
Health Insurance Medical Loss Ratios – How Will The Definitions Between Healthcare, Other Administrative Costs and Profits Be Spelled Out – May Need Some Algorithms to Figure It Out
Perhaps HHS was maybe not aware of all the data functionality here that insurers have to analyze (what they do best) in order to comply within this time frame, as the investor relationships have to come first by law. Oh the complications of Health IT today and how it impacts deadlines imposed and makes things complicated perhaps for those who are on a non participant level at times. It affect everything and we are finding other examples too of deadlines not being met, again technology and the algorithms for decisions impact all, and why it is important today to have leaders with some Health IT knowledge and participation. BD
The National Association of Insurance Commissioners (NAIC) submitted a letter June 1 to the U.S. Department of Health and Human Services (HHS) saying it was delaying its report on how health insurers should calculate their medical loss ratios.
The NAIC was asked by HHS to offer guidance on how to determine if insurers are meeting new health care reform requirements for medical loss ratios. The NAIC originally had until Dec. 31 to complete its work, but then was told to complete it by June 1 to ensure federal regulators had time to implement the rules, which take effect in 2011.
Last month, the NAIC said just 27 states had responded to its request for information on state MLRs. The organization cited time constraints for the limited response.
The federal health insurance reform law requires insurers to meet minimum medical loss ratios — the percentage of premiums collected by insurers actually spent on care that is not administrative costs or profits.
Cline called the initiative a “top priority” for the NAIC, which will determine how expenses paid by insurers such as technology costs, wellness services, taxes and administration costs will affect the new requirements. Companies that do not pay the required proportion of collected premiums back to consumers in the form of claims paid and benefits provided must supply rebates.
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