News and Blog

Wednesday, 18 January 2012
CMS Moves Closer To Sunshine Provisions In ACA.
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The New York Times (1/17, A1, Pear, Subscription Publication) reports on its front page, "To head off medical conflicts of interest, the Obama administration is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment." According to "the new standards, if a company has just one product covered by Medicare or Medicaid, it will have to disclose all its payments to doctors other than its own employees." The Times noted that "the new requirements, or something very similar, will take effect soon; in fact, they are overdue."
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Posted on 01/18/2012 10:38 AM by David M. Widmer
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Wednesday, 11 January 2012
State insurance exchanges and Medical Loss Ratios
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Who woulda thunk it? Did you know the state health insurance exchanges will be excluded from the new Federal MLR requirements? (Beginning not later than January 1, 2011, and subject to the definitions established through NAIC/HHS regulation, large‐group plans (101 employees or more) that spend less than 85% of premium revenue and small‐group (one to 100 employees) and individual plans that spend less than 80% of premium revenue on clinical services and activities to improve health care quality must provide a rebate to enrollees.)
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Posted on 01/11/2012 10:37 AM by David M. Widmer
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