Jesse Caplan,a Member of the Firm in the Health Care and Life Sciences practice, in the Washington, DC, office, and Serra Schlanger,a Law Clerk (admission pending) in the Health Care and Life Sciences practice, in the Washington, DC, office, cowrote an article titled “HHS Announces First Insurance Premium Rate Review Determinations: Implications for Insurance Carriers and Future Rate Reviews.”
Following is an excerpt:
On Nov. 21, 2011, the Center for Consumer Information and Insurance Oversight (”CCIIO”), in the Centers for Medicare & Medicaid Services (”CMS”), announced its determination that a health insurance premium rate increase of 11.58 percent in the small group market in Pennsylvania represented an ”unreasonable” rate increase, while an 11.10 percent increase in the individual market in Montana did not. These long-awaited determinations represent the first application of CMS’s rate review regulations under federal health reform. The article discusses these first federal rate review determinations and their implications for insurance carriers and future insurance premium rate reviews.
Copyright © 2011 by the Bureau of National Affairs, Inc. HIR ISSN 2154-8986