03-19-2010, 02:47 PM
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Confirmed User
Industry Role:
Join Date: Mar 2004
Location: Rock Hill, SC
Posts: 5,370
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Quote:
Originally Posted by The Demon
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She is wrong... section 2718. AP has a pretty high percentage of bad reports on average... I don't think they should even be sending out opinion pieces... but they do.
Quote:
‘SEC. 2718. BRINGING DOWN THE COST OF HEALTH CARE COVERAGE.
‘(a) Clear Accounting for Costs- A health insurance issuer offering group or individual health insurance coverage shall, with respect to each plan year, submit to the Secretary a report concerning the percentage of total premium revenue that such coverage expends--
‘(1) on reimbursement for clinical services provided to enrollees under such coverage;
‘(2) for activities that improve health care quality; and
‘(3) on all other non-claims costs, including an explanation of the nature of such costs, and excluding State taxes and licensing or regulatory fees.
The Secretary shall make reports received under this section available to the public on the Internet website of the Department of Health and Human Services.
‘(b) Ensuring That Consumers Receive Value for Their Premium Payments-
‘(1) REQUIREMENT TO PROVIDE VALUE FOR PREMIUM PAYMENTS- A health insurance issuer offering group or individual health insurance coverage shall, with respect to each plan year, provide an annual rebate to each enrollee under such coverage, on a pro rata basis, in an amount that is equal to the amount by which premium revenue expended by the issuer on activities described in subsection (a)(3) exceeds--
‘(A) with respect to a health insurance issuer offering coverage in the group market, 20 percent, or such lower percentage as a State may by regulation determine; or
‘(B) with respect to a health insurance issuer offering coverage in the individual market, 25 percent, or such lower percentage as a State may by regulation determine, except that such percentage shall be adjusted to the extent the Secretary determines that the application of such percentage with a State may destabilize the existing individual market in such State.
‘(2) CONSIDERATION IN SETTING PERCENTAGES- In determining the percentages under paragraph (1), a State shall seek to ensure adequate participation by health insurance issuers, competition in the health insurance market in the State, and value for consumers so that premiums are used for clinical services and quality improvements.
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http://breakingnews.newscred.com/aut...e/erica-werner |
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