Congressional Medical Loss Ratio Probe

Republicans on the House Energy and Commerce Committee want to know whether HHS pushed state regulators into a set of policy recommendations that could hurt insurance agents. HHS’s regulations on the medical loss ratio (MLR) are nearly identical to the model regulation crafted by the National Association of Insurance Commissioners, and Republicans seem to suspect that HHS might have led the NAIC down a very specific path.

The lawmakers asked NAIC officials Wednesday whether HHS ever said it would refuse to certify the group’s recommendations unless certain provisions were written in certain ways. Neither regulation excludes insurance agents’ commissions from the MLR calculation, which the NAIC said it did not have the authority to recommend. The GOP letter (attached) asks whether HHS provided legal analysis on that issue.

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

House E&C Letter HHS Lead NAIC Down MLR Path 120711.pdf


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