Bob Atlas Quoted in “Final Medicaid Managed Care Rule Keeps 85% MLR Requirement with Only Tweaks”

AIS Health Business Newsletter

Bob Atlas, a Strategic Advisor and President of EBG Advisors, Inc., was quoted in AIS Health Business Newsletter, in “Final Medicaid Managed Care Rule Keeps 85% MLR Requirement with Only Tweaks.”

Following is an excerpt:

"CMS hasn't backed down from the 85% minimum MLR provision but acknowledges 'there is no statutory basis to implement a federal mandatory minimum MLR or a remittance requirement in Medicaid,'" Bob Atlas, president of the EBG Advisors unit of health care law firm Epstein, Becker & Green and a longtime Medicaid managed care consulting executive, tells AIS. "CMS instead will use its power to judge whether capitation rate-setting methods meet the actuarial soundness test to, indirectly, assess whether at least 85% of MCOs' income will go toward health care items. It remains to be seen whether states will in fact impose the standard and enforce it through the collection of remittances from plans."