Final MLR rule for Medicare Advantage and Part D released by CMS

05/20/2013 | Health Data Management

A final rule was issued by the CMS to enforce 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. Insurers that miss the mark for how much must be spent on patient care could be hit with monetary penalties or even loss of their contracts.

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