Download PDF Report >>> Medical Quality Activities
On April 14, 2010 the Federal Register published a notice for comments to PHS Act Section 2718(c) directing the National Association of Insurance Commissioners (NAIC) to establish:
- uniform definitions of the activities including defining which activities constitute activities that improve quality, and
- standardized methodologies for calculating measures of these activities that to take into account:
- the special circumstances of smaller plans,
- different types of plans, and
- newer plans
These uniform definitions and standardized methodologies will be subject to the certification of the Secretary.
For years, FASB (Financial Accounting Standards Board) has provided guidelines for SG&A expenses that apply to all industries. With this PHS Act directive, health insurers can convert some SG&A expenses into medical expenses to raise their MLR. Since the law allows activities that improve quality to be considered medical expenses, some SG&A expenses will qualify. What does and does not improve quality and not violate FASB standards is the issue.
Expenses can be divided into Continue reading
Filed under: Analyses, Healthcare Reform, Internal Revenue (IRS) | Tagged: allocated expense, FASB, Federal Register, Financial Accounting Standards Board, fixed expense, NAIC, National Association of Insurance Commissioners, PHS Act, section 2718, semi-variable expense, SG&A, standardized methodologies, uniform definitions, variable expense | Leave a comment »
Health Reform Trends, Research and Analysis 
Attacks Can’t Obscure Health Law’s Valuable Benefits
Download PDF version Report>> Attacks cant obscure benefits-Huff Post
Huffington Post Posted: September 23, 2010 09:04 AM
http://www.huffingtonpost.com/andrew-kurz/attacks-cant-obscure-heal_b_735873.html
Attacks Can’t Obscure Health Law’s Valuable Benefits
After decades of trying, health care reform is finally a reality. The Affordable Care Act (ACA) is sweeping in scope (it has more than 300 sections) and takes four years to implement. Critics say Americans don’t want it, but if that’s true, it’s only because of false claims by those who do not know what its provisions are or who are being spun by people who have an economic or political interest in blocking the law.
Health reform provides coverage to millions of people while correcting many current and serious defects. It isn’t perfect, but it has countless positive elements being ignored by critics. One key example is Section 2718, “Bringing down the cost of health care coverage,” which takes effect today (September 23). It brings sorely needed cost-control mechanisms while retaining health insurers’ ability to innovate. The provisions of section 2718 are eminently reasonable, and if the atmosphere were not so politically charged, they would receive strong bipartisan support.
Insurance accounting used to be straightforward. The hospital sent a bill. The insurer paid most of it, and forwarded the balance to you or your employer. With the advent of for-profit insurers, which now dominate the industry, accounting and classification of costs have become creative enterprises. Continue reading →
Filed under: Commentary, Congress, Healthcare Reform | Tagged: ACA, accounting standards, Affordable Care Act, better cost comparisons, competition, cost control, credit card, definitions, excess profits, health promotion, Huffington Post, medical errors, medical loss ratio, MLR, NAIC, National Association of Insurance Commissioners, ObamaCare, patient safety, section 2718, transparency, wasteful admin | Leave a comment »