Categorized | Colorado News, National News, News

CMS Final Rule Gives States/Plans More Control

The Centers for Medicare and Medicaid Services has issued a final ruling for 2019 effecting the individual and small-group health insurance markets.  A main take-away of the final rule is the flexibility that is given to  states and health insurers to tailor their essential health benefits under the Affordable Care Act.  The ruling encourages  innovation in plan designs that more directly meet local needs.

States will also be allowed more discretion in setting a medical-loss ratio percentage.  Current law requires that 80 percent of premium income be spent on healthcare and quality improvements.  Also of note, CMS has increased the trigger for plan review.  It will now be premium increases in excess of 15 percent for 2019.


Read more at Healthcare Finance.

Read more at Modern Healthcare.





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