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CMS Announces Medicare Advantage and Prescription Drug Program MLR Proposed Rule; Largely Follows Commercial MLR Rules
Crowell Moring Link to more items from this source
[Guidance Overview]
Feb. 25, 2013

"The proposed rule generally tracks the requirements set forth in the medical loss ratio for commercial plans, albeit with some Medicare-specific changes. By way of summary, the commercial MLR rules generally require commercial health insurers to spend at least 80% (in the individual and small group markets) and 85% (in the large group market) of premiums on provision of care. Insurance companies that fail to do so are required to provide rebates to beneficiaries."

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