This Client Alert updates and replaces the Implementing Health and Insurance Reform alert issued on August 19, 2011, titled “HHS Publishes Health Insurance Premium Rate Review Final Rule Effective September 1st and List of States with Effective Rate Review Programs.”
On May 23, 2011, the Center for Consumer Information & Insurance Oversight (CCIIO), in the Centers for Medicare & Medicaid Services (CMS) of the United States Department of Health and Human Services (HHS) published its Final Rule implementing Section 2794 of the Public Health Service Act (PHSA). This Section requires HHS to establish a process for the review of “unreasonable” health insurance premium rate increases in the individual and small group markets. The Final Rule remains largely unchanged from the Proposed Rule, with important exceptions. The Final Rule and the key changes are summarized in this Client Alert.