Academy Activities

On March 31, the Risk Sharing Work Group submitted a letter to the Centers for Medicare & Medicaid Services (CMS) on the 2014 medical loss ratio (MLR) annual reporting form, specifically addressing the expansion of the form to include risk corridor calculations.

Several updates were provided to the NAIC’s Long-Term Care Working Group on March 27 at the NAIC’s Spring 2015 National Meeting in Phoenix:

• The Academy’s Long-Term Care Terminations Work Group presented an update on the progress made in developing a recommendation on LTC terminations and next steps.
• The Long-Term Care Principle-Based Work Group updated the working group on development of a principle-based approach model and discussed a timeline for completion.
• The Long-Term Care Credibility Monograph Work Group presented its progress in drafting a monograph that addresses LTC credibility.

Legislative/Regulatory Updates

On March 18, the IRS, the Employee Benefits Security Administration, and CMS released amendments to the regulations regarding excepted benefits. These final regulations are effective on May 18, 2015.

On March 26, the U.S. House overwhelmingly passed bipartisan legislation, the Medicare Access and CHIP Reauthorization Act (MACRA), to eliminate Medicare’s sustainable growth rate (SGR) formula and set up a new payment system, and to reauthorize the Children’s Health Insurance Program (CHIP) for two years. The Senate is expected to quickly take action when it returns the week of April 13. President Obama has endorsed the legislation.

On March 31, the Center for Consumer Information and Insurance Oversight (CCIIO) released technical guidance regarding rate review requirements. The focus of the guidance was on when premium rates can be rounded to the nearest dollar.

In the News/Media Activities

The Academy issue brief, Potential Implications of the Small Group Definition Expanding to Employers with 51-100 Employees, was cited by several media outlets covering the Affordable Care Act (ACA) small group redefinition provision scheduled to take effect in 2016.

A Politico Pro subscriber-only story reported that the Department of Health and Human Services (HHS) is considering delaying the ACA provision and cited analysis from the Academy’s issue brief to help readers understand the provision’s implications.

The Washington Examiner cited the Academy’s issue brief in a story reporting that seven U.S. senators have asked HHS to delay the provision.

Additionally, the Academy’s issue brief was the subject of a blog post by a law firm. The post cited the Academy’s analysis to help readers understand the effect of this change in definition.

Media reports citing the Health Practice Council’s Feb. 24 letter to HHS Secretary Sylvia Mathews Burwell continued with mentions in stories by Politico Pro, Insurance Business America, and the Deloitte health blog. Visit the Academy Newsroom to see the full list of media citations of the Academy’s letter in coverage of King v. Burwell.

Upcoming Health Care Reform Events

The Impact of Rising Drug Costs on Patients, Providers
Briefing: April 9, 9:30 a.m.-11:00 a.m. EDT, Capitol Visitors Center: Congressional Meeting Room South, Washington, DC (no fee charged)
Sponsor: Campaign for Sustainable Rx Pricing

A Conversation with CCIIO on the URRT and Actuarial Memorandum Instructions
Webinar: April 10, Noon-1 p.m. EDT (no fee charged)
Sponsor: American Academy of Actuaries

Panelists from the CCIIO will answer your pressing questions about rate review and disclosure under the ACA, specifically the Unified Rate Review Template and Actuarial Memorandum.

Save the Date—Exploring Global Health Care Cost Drivers: South Africa and the United States
Webinar: May 13, 9:30 a.m. EDT (no fee charged for Academy members)
Sponsor: American Academy of Actuaries

Join us for the second webinar in this series, which will provide a unique opportunity to learn about the successes and challenges that both South Africa and the United States have experienced as they’ve worked to identify and address particular cost drivers.

For a complete listing of upcoming and recent health care reform events, click here.