New rule regulates insurance company spending

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Beginning in 2011, insurance companies will need to spend 80% to 85% of every premium dollar either on direct patient care or on efforts to improve quality of care, the Department of Health and Human Services announced today.

A provision within the Affordable Care Act, the “medical loss ratio,” will assure that insurance companies spend less consumer money on administrative costs and profits – such as executive salaries, marketing and overhead costs – and invest more towards providing the best care possible.

 “These new rules are an important step to hold insurance companies accountable and increase value for consumers,” Health and Human Services Secretary Kathleen Sibelius said in a press release.

Under the provision, insurance companies are now required to publicly report how they spend premium dollars, and those companies not meeting medical loss ratio standards must provide rebates to their customers.

HHS estimates that about 9 million Americans will be eligible for a rebate as of 2012, with the average refund totaling as much as $164 per person, or $1.4 billion total.

“As we build a bridge to 2014, when better more affordable options are available to consumers, these rules will help make health insurance fairer for consumers now,” Jay Angoff, director of the office of consumer information and insurance oversight at HSS, said in a statement.

In other Affordable Care Act news, Secretary Sibelius  announced that $290 million in funding would be allocated to the National Health Service Corps Loan Repayment Program this year, in efforts to provide greater access to health care.

Primary care medical, dental and mental health clinicians who participate in the program and work for two years in medically underserved areas are eligible to receive up to $60,000 in aid to help repay student loans.

In addition to higher monetary awards this year, the Affordable Care Act will offer providers more flexibility, with the option of working half time to fulfill service obligations, and will provide credit for some teaching hours. Those interested can apply online, here.

Health officials project that these funding opportunities will help bring more than 15,000 new primary care professionals into the workforce by 2015.

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