《患者保护与平价医疗法案》下的医疗损失率要求。有意见征求期的最终规则。
Medical loss ratio requirements under the Patient Protection and Affordable Care Act. Final rule with comment period.
出版信息
Fed Regist. 2011 Dec 7;76(235):76574-94.
PMID:22165170
Abstract
This final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to address the treatment of "mini-med" and expatriate policies under these regulations for years after 2011; modify the way the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit expenditures; and revise the rules governing the distribution of rebates by issuers in group markets.
摘要
本带有意见征求期的最终规则修订了《公共卫生服务法》下医疗保险发行人的医疗损失率（MLR）要求的实施条例，以解决2011年后这些条例对“迷你医保”和外派人员保险政策的处理方式；修改条例对国际疾病分类第十版（ICD - 10）转换成本的处理方式；更改扣除社区福利支出的规则；并修订团体市场中发行人返利分配的管理规则。
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