Grants to Help States Review Insurer Rates

The Department of Health and Human Services is making available a $1 million grant to each state and the District of Columbia to create and strengthen their health insurance rate review processes.


The Department of Health and Human Services is making available a $1 million grant to each state and the District of Columbia to create and strengthen their health insurance rate review processes.

The $51 million in available grants is the first round of a $250 million grant program over five years that is authorized under the health care reform law, or Affordable Care Act. To receive funds, a state must submit a plan for how it will use the grant to develop or enhance its process of reviewing and approving, disapproving, or modifying health insurance premium requests.

States in the application must describe the extent to which their current information technology systems support the rate review process. "States may develop new analytic capacities to assess the validity of rate increases and improve the I.T. infrastructure that supports health insurance rate review functions, including more robust data analysis and data exchange capabilities both within the State as well as with the Federal government in preparation for enhanced data reporting requirements that will be part of future HHS regulatory requirements," according to a HHS request for applications posted at grants.gov.  "For example, states may request funding to plan, develop and implement enhanced electronic filing and approval processes for rates and policy forms, electronic reporting of financial data used by insurance regulators, and online fraud reporting."

States also may choose to enhance transparency by posting to a public Web site, in layman's terms, insurers' rate filings and justification for the increase. They also could require insurers to post the information on their own Web sites and give consumers advance notice of approved rate increases.

Grant applications are due by July 7 with first-year awards announced on August 9. The Funding Opportunity Number is RFA-FD-10-999. There is no cost sharing or matching requirement for the grants.

--Joseph Goedert