Final Medical Loss Rule Includes ICD-10 Provision

Published
  • December 05 2011, 12:15pm EST

The Centers for Medicare and Medicaid Services has published a final rule, with a comment period, establishing health insurers' "medical loss ratios," including provisions to account for ICD-10 conversion costs.

Implementation of medical loss ratios is mandated under the Affordable Care Act. To reduce excessive costs, the reform law requires insurers spend a minimum amount of revenue from premiums on payment for clinical care. This is the "medical loss ratio" and the minimum level is set at 85 percent for the large group market and 80 percent for the small group market.

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access

Comments