Benefits Forward » Articles, White Papers and Other Information

Final Medical Loss Ratio Rules

administrator — Mon, 14 May 2012 14:02:46 +0000

The Centers for Medicare & Medicaid Services and HHS have published its final rule governing Medical Loss Ratio requirements.

Document Excerpt

This final rule amends the regulations implementing medical loss ratio (MLR) standards for health insurance issuers under the Public Health Service Act in order to establish notice requirements for issuers in the group and individual markets that meet or exceed the applicable MLR standard in the 2011 MLR reporting year.

Link http://www.ofr.gov/OFRUpload/OFRData/2012-11753_PI.pdf

U.S. Chamber’s Report on Path Forward for Private Retirement System

administrator — Tue, 24 Apr 2012 16:10:14 +0000

The U.S. Chamber of Commerce provides a White Paper on possible approaches to bolster the private retirement system.

Document Excerpt

The U.S. Chamber of Commerce Employee Benefits Committee has developed this white paper to offer a path on initiatives and reforms that build on existing institutions and approaches to bolster the voluntary employment-based retirement benefits system and enhance retirement security for workers. The ideas in this paper represent a long-term view of retirement changes that are needed.

Link http://www.uschamber.com/sites/default/files/reports/1204Private_Retirement_Paper.pdf

GAO Study On Defined Contribution Plan Approaches in Other Countries

administrator — Tue, 24 Apr 2012 16:05:29 +0000

The GAO was asked to review the approaches taken by other countries with respect to defined contribution plans and has issued this report.

Document Excerpt

In overseeing DC plans and service providers, regulatory agencies in the countries GAO reviewed use risk-based approaches to target practices deemed most likely to harm participants and to develop preventative measures. While the role of service providers varies, DC plans and service providers in the 4 countries GAO reviewed are overseen by multiple agencies—primarily a pensions regulator and a securities regulator. In each of these countries, the pensions regulator is the agency that regularly collects data on service provider fees, as well as other plan features, which are used to inform their oversight activities. In particular, in several of these countries, the pensions regulator uses these data as part of a risk-based approach to identify service provider practices that may harm participants, instead of relying only on a compliance-based approach.

Link http://www.gao.gov/products/GAO-12-328

Proposed Rule to Adopt Unique Identifier

administrator — Wed, 11 Apr 2012 14:08:41 +0000

HHS has released a proposed rule to adopt a standard for a national unique health plan identifier (HPID).

Document Excerpt

It proposes the adoption of the standard for a national unique health plan identifier (HPID) and requirements or provisions for the implementation of the HPID. This rule also proposes the adoption of a data element that will serve as an other entity identifier (OEID), an identifier for entities that are not health plans, health care providers, or “individuals,” that need to be identified in standard transactions. This proposed rule would also specify the circumstances under which an organization covered health care provider must require certain noncovered individual health care providers who are prescribers to obtain and disclose an NPI.

Link http://www.ofr.gov/OFRUpload/OFRData/2012-08718_PI.pdf

Fact Sheet: HHS Proposes HIPAA Standard for a Unique Health Plan Identifier

administrator — Wed, 11 Apr 2012 14:03:17 +0000

HHS proposes to adopt an “other entity identifier” under HIPAA.

Document Excerpt

A proposed rule announced today by the Department of Health and Human Services (HHS) would establish a unique health plan identifier (HPID) under Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards for electronic health care transactions. Further, the rule would adopt a data element that will serve as an “other entity” identifier (OEID) for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. The rule proposes an addition to the National Provider Identifier (NPI) requirements. Finally, the proposed rule would delay by one year, until Oct. 1, 2014, the date by which covered entities must comply with International Classification of Diseases, 10^th Edition diagnosis and procedure codes (ICD-10).

Link http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4332

List of Counties Requiring “Culturally and Linguistically Appropriate” Notices

administrator — Mon, 02 Apr 2012 21:23:33 +0000

The Departments of Health and Human Services releases a list of counties for which covered group health plans must issue relevant notices in a “culturally and linguistically appropriate” manner for 2012.

Document Excerpt

The list below includes all counties which meet or exceed the 10 percent threshold for the 2006-2010 ACS data and is applicable for 2012. This list will be updated annually.

Link http://www.cciio.cms.gov/resources/factsheets/clas-data.html

Transcript from Supreme Court

administrator — Thu, 29 Mar 2012 14:10:43 +0000

Transcript of oral arguments on day three of the Supreme Court’s hearing on the Affordable Care Act.

Link http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-400.pdf

Audio from Severability Oral Arguments

administrator — Thu, 29 Mar 2012 14:06:57 +0000

Audio of oral arguments before the Supreme Court on day three dealing with issues of severability of the individual mandate from the remainder of the Affordable Care Act.

Link http://www.supremecourt.gov/oral_arguments/argument_audio_detail.aspx?argument=11-400

Oral Arguments on Individual Mandate

administrator — Wed, 28 Mar 2012 14:18:56 +0000

Transacripts of the oral arguments before the Supreme Court on the constitutionality of the individual mandate enacted as part of the Affordable Care Act.

Link http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-398-Tuesday.pdf

Audio from Tuesday’s Supreme Court Hearing

administrator — Tue, 27 Mar 2012 22:29:25 +0000

The following is an audio of today’s Supreme Court oral arguments on the constitutionality of the individual mandate enacted as part of the Affordable Care Act.

Link http://apne.ws/Hft6z3