Final MLR rule for MA and Part D released

CMS has issued final regulations on medical loss ratio requirements for the Medicare's prescription drug benefit and Medicare Advantage. The new rule sets an 85% MLR for large market policies and 80% for small market and individual plans. "We consider agents and brokers fees as non-claims costs and therefore impermissible as being considered included as incurred claims," CMS said. "We also exclude marketing as a quality improving activity."

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National Underwriter Life & Health · Health Data Management

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