Milestone: Adopt a systematic rate review process
By creating greater oversight and accountability, a systematic rate review process aims to prevent unreasonable premium increases and to keep health insurance premiums affordable.
*Milestone details:
*Full name: Adopt a systematic rate review process.
*Relevance to the ACA:
The ACA requires the Secretary of HHS and states to collaborate on a rate review process. Relevant sections include:
§1003 - Creates a premium rate review process established by the Secretary of HHS in collaboration with states, beginning with plan year 2010. Insurance issuers are required to justify to the Secretary of HHS and to the state any “unreasonable premium increase” prior to its implementation. Establishes premium review grants for states from 2010 through 2014. States that receive grants must provide the Secretary of HHS with data on premium increases in the state as well as recommend plans to be excluded from the Exchange due to a pattern of excessive rate increases.
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District of Columbia
This memo provides a summary of S8088, requiring prior approval of insurance rate changes and raising the MLR to 82%. Access the memo here: http://www.statereforum.org/sites/default/files/nys_prior_approval_legis...
District of Columbia
This report by the New York State Health Foundation details the challenges and opportunities NY faces in implementing reform, including Exchange, benefit design and payment issues. Access the report here: http://www.statereforum.org/sites/default/files/nyroadmappaper_aug2010.pdf
District of Columbia
This letter from Gov. Patterson to Sec. Sebelius describes the current ability of New York to enforce consumer protection provisions, as they related to health insurance policies, outlined in the ACA. The document indicates that NY's current laws were found to be highly compatible with the ACA and the state would consider legislation in the 2011 session to make any amendments to current laws necessary to meet or exceed ACA requirements.
Access the letter here:
http://www.statereforum.org/sites/default/files/ny_aca_consumer_protecti...