Florida is the latest state to be denied an exception to the medical-loss-ratio standard that requires individual and small-group plans to spend at least 80% of premium dollars on medical care, a CMS official said.
Late News: CMS denies Florida's request for exception to MLR rule
In its application, Florida’s Office of Insurance Regulation had requested an adjustment of the standard so the state would have to meet lower thresholds: 68% in 2011; 72% in 2012; and 76% in 2013. The decision to not grant Florida’s request is for the current calendar year, but “the impact of our decision is to ensure consumers get the benefits this year and through 2014,” Steve Larsen, director of CMS’ Center for Consumer Insurance & Information Oversight, said during a call with reporters.
Larsen also noted that his office received “an unprecedented level of public comment on this particular application,” but did not speculate on the reasons why the correspondence was greater for this request. Larsen’s 16-page letter to Kevin McCarty, commissioner of the Florida Office of Insurance Regulation, noted that CCIIO had received a petition signed by more than 3,000 Florida consumers who said implementation of the MLR is “long overdue” in the state. The letter also stated that eight issuers in the state have MLRs of 80% or higher, while one other issuer is close to meeting that standard and two others are expected to meet it in 2012.
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