PPACA Blog

Aug 18, 2010

Insurers' Medical Spending


Category:PPACA 
Posted by: Neal

Commissioners Unanimously Approve Plan For Insurers' Medical Spending.

Politico (8/18, Kliff) reports, "The National Association of Insurance Commissioners approved Tuesday morning a preliminary outline of what insurers will be able to count as medical costs, a document necessitated by the health reform bill's requirement that insurers spend at least 85 percent of subscriber premiums on medical costs in the large group market and 80 percent for small group and individual plans." Although they had "divided political views on the health reform law, all commissioners voted together to approve the document, a move forward that drew the ire of insurers." Notably, "they approved amendments that narrow inclusions of utilization review in the calculation and expand the definition of 'wellness and health promotion activities' to include 'public health marketing campaigns that are performed in conjunction with state or local health departments.'"

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