Michigan opts not to appeal feds' MLR rule

Jan 5 2012

The state was one of 13 seeking an exemption from the health law's medical-loss ratio requirement that insurance companies spend at least 80 percent of premiums on medical care. Others, however, get a 30-day extension. Also in the news, the Department of Health and Human Services named 73 advisers to work with the Center for Medicare and Medicaid Innovation. And, the American Hospital Association registered concern about some antitrust policies regarding accountable care organizations. Meanwhile,  Politico lists some of the key health policy dates to watch in 2012.  

Detroit Free Press: Michigan Won't Challenge New Rule: Insurers Must Spend 80% Of Premiums On Health Care
Michigan will not appeal a recent federal decision requiring health insurance companies to spend at least 80 cents of each dollar collected on premiums for medical care. Jason Moon, spokesman for Michigan's Office of Financial and Insurance Regulation, said today that the office won't appeal the Dec. 19 ruling by the U.S. Department of Health and Human Services. Michigan was one of 13 states seeking the exemption to a provision of federal health reforms (Anstett, 1/3).

Congressional Quarterly: Texas, Oklahoma Get Another Month Of Review On MLR Requests
The Department of Health and Human Services has granted 30-day extensions to Oklahoma and Texas to phase in requirements under the health care law that deal with medical payouts. The Texas Department of Insurance application, in particular, has attracted congressional attention, with Democratic lawmakers from the state saying it would be a "tremendous mistake" and urging HHS to deny the request for delay (Norman, 1/3).

Modern Healthcare: AHA Fears Tightening Of Antitrust Restrictions Regarding ACOs
Although observers roundly praised federal officials for loosening the antitrust and abuse rules on accountable care organizations, the American Hospital Association is protesting what it says are efforts by regulators to move back toward stricter enforcement over time ... on Jan. 3, the AHA noted in a response to a public request for comment that it was disappointed in a little-noticed announcement from the CMS that it planned to tighten some ACO fraud-and-abuse waivers by narrowing legal definitions after two years of experience with the program (Carlson, 1/3).

The Hill: HHS Names 73 'Innovation Advisors'
The advisers will ultimately work with the Center for Medicare and Medicaid Innovation, which was created by the health care reform law to help improve the health care delivery system. The advisers represent 27 states and the District of Columbia. Part of their mission is to work with local health care systems and coordinate those delivery-system efforts with the Innovation Center (Baker, 1/3).

Congressional Quarterly: New Program Enlists Medical Professionals to Change Health Systems
The Center for Medicare and Medicaid Innovation announced Tuesday that officials will pay 73 doctors, health care executives, academics and other health care professionals $20,000 each this year to spend up to 10 hours per week trying to change health systems in ways that the center's leaders believe will improve care (Adams, 1/3).

The Washington Post: Wonkblog: Five Health Reform Dates To Watch In 2012
Health reform had a big year in 2010. … And it'll have another big year in 2014. That's when the individual mandate kicks in, pre-existing conditions end and Medicaid expands to cover 16 million more Americans. But 2012 won't be all quiet on the health care front: The Obama administration is laying a policy foundation for 2014, while health reform opponents try to stop the law altogether (Kliff, 1/4).

In related news, the latest developments regarding the Supreme Court's health law review -

The Wall Street Journal's Law Blog: Readers Poll: 55.6% In Favor Of Televised Arguments In Health-Care Case
The yeas have it. But not by too wide a margin. Of the roughly 500 voters, 55.6 percent favored televising the Supreme Court arguments in the health-care overhaul case and 44.4% were against it. In a recent USA TODAY/Gallup Poll, by comparison, 72 percent of the people surveyed said they think the Supreme Court should allow cameras in the court for arguments in the health-care case (Palazzolo, 1/3).

Congressional Quarterly: The 2012 Road To Overhaul May Well Wind Beyond High Court
Big pieces of the health care law could easily remain standing even if the U.S. Supreme Court rules later this year that its individual mandate is unconstitutional. And many of the provisions that could survive still have to be implemented. The upshot: 2012 looks like it could be a busy year for health care law implementation, beyond the big job of creating state-based health insurance exchanges (Reichard, 1/3).

Politico Pro: SCOTUS Dates To Watch
The health care reform law will head into the Supreme Court in less than 90 days for a record-setting, mammoth three days of oral arguments. Until then, expect a slew of paperwork as the federal government, the 26 states and the National Federation of Independent Business, as well as outsiders, file briefs on the four separate issues the court has said it would address: whether the individual mandate and Medicaid provisions are constitutional; whether the Anti-Injunction Act bars review of the mandate until after 2014; and what pieces of the law should fall if the mandate is ruled unconstitutional (Haberkorn, 1/3).