Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress

Kirchhoff, Suzanne M.

Library of Congress. Congressional Research Service.

关键词: Health policy;    Health insurance;    Comprehensive health care;    Congress;   

RP-ID  :  R42735
RP-ID  :  R42735_2014Aug26

美国|英语

来源: UNT Digital Library

【 摘 要 】

This report provides a detailed description of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requirements for Medical Loss Ratio (MLR) reporting and rebates as specified in regulations, including components of the MLR formula, state flexibility and waivers, and the nature of rebates to policyholders. The report also addresses issues that have been raised about the MLR provisions since the ACA was enacted, namely the treatment of insurance commissions paid to brokers and agents.