Medical-loss ratio regulations expected Monday

Federal regulations detailing how health plans can meet new requirements that they spend 80 percent or more of premiums on medical care are expected to be announced on Monday, a source with the National Association of Insurance Commissioners tells The Hill. 

The NAIC adopted medical-loss ratio definitions last month and sent them to the Department of Health and Human Services for certification. HHS isn't expected to make drastic changes to the state insurance commissioners' proposal but several issues remain controversial — including the accounting of taxes, agent and broker fees and quality improvement measures that don't directly improve patient care, such as fraud prevention.

The regulation was transmitted Thursday to the Office of Management and Budget, which allows other departments to look at it and weigh in. Once a regulation is in OMB's hands it can be adopted fairly rapidly, unless the White House or another department objects.