The American Hospital Association praised HHS for its approach to reviewing insurance premium increases, while America's Health Insurance Plans outlined nine recommendations to modify the agency's recent proposed rule that AHIP says does not address “cost containment of the underlying drivers of healthcare costs.”
AHA, AHIP comment on HHS proposed regulations
In their respective letters this week to HHS, the two groups offered comments on the agency's proposed regulations—issued in December—that will require health insurers to disclose and justify premium rate increases of 10% or more beginning July 1, 2011. The AHA was generally pleased with the rule (PDF), saying that it provides for greater transparency in how plans will be held publicly accountable, while also establishing a federal-state collaboration that relies on states' review of premiums unless there is no effective state process, in which case the federal government would conduct the review.
Meanwhile, AHIP—which cited CMS data showing that health insurance accounts for 4% of all health expenditures, while hospitals, physicians, pharmaceuticals, home healthcare and other components make up the rest—offered a series of recommendations for the proposed rule, including one that would delay the effective date of the rule to begin July 1, 2012. “There is inadequate time between now and July 1, 2011, for states to establish ‘effective review' programs if such programs are not already in place for both the individual and small group markets,” said the 13-page letter from Daniel Durham, executive vice president of policy and regulatory affairs at AHIP.
The group also urged the CMS to reconsider its established 10% benchmark, preferring instead that states be permitted to determine their own approaches. One such approach could include the development of metrics for an outlier approach based on recent rating filings, according to a footnote in the letter.
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