Tag Archives: health insurance premium rate review

HHS Publishes Health Insurance Premium Rate Review Final Rule Effective September 1st and List of States with Effective Rate Review Programs

EBG Introduces Interactive National Rate Review Scorecard

by Jesse M. Caplan and Lynn Shapiro Snyder

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.

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HHS Publishes Health Insurance Premium Rate Review Proposed Regulations – Implications for Health Insurance Issuers, Providers, and the Health Care Marketplace

On December 21, 2010, the United States Department of Health and Human Services (HHS) released for public comment much anticipated proposed regulations implementing Section 2794 of the Public Health Service Act (PHSA) which requires HHS to establish a process for the review of “unreasonable” health insurance premium rate increases in the individual and small group markets. The proposed regulations, which would apply to rate increases in the individual and small group markets filed or effective on or after July 1, 2011, set an initial threshold for mandatory review of any rate increase at or above 10 percent. The proposed regulations were published in a Notice of Proposed Rulemaking (NPRM) on December 23, 2010 in the Federal Register, and public comments are due by 11:59 PM on February 22, 2011.[1]

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