CMS to Perform Rate Reviews in 10 States

Margaret Dick Tocknell, for HealthLeaders Media , July 21, 2011

Ten states have been notified that the Center for Medicaid & Medicare Services will be taking over responsibility for reviewing certain health insurance premiums increases proposed by insurers in their states.

The move, effective Sept. 1, 2011, is part of Affordable Care Act regulations that require significant rate increases in all states to be reviewed by independent experts and disclosed to the public. CMS had hoped that all states would have their own review programs up and running by September and even earmarked $250 million in grants to get the process underway. But some states don’t have the legal authority or resources to effectively review health insurance rates. In those cases the federal government is stepping in.

In Montana and Idaho politics played a role in limiting the review process preparation. The Montana legislature defeated a bill that would have given its state auditor the authority to review rates and negotiate with insurers. According to the Billings Gazette, the Republican-controlled Legislature “wanted nothing to do with implementing the new federal health reform law.”

In Idaho, Gov. C.L. "Butch" Otter's signed an executive order that prohibits the state from carrying out any component of the ACA, according to reports in the Idaho Statesman.


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1 comments on "CMS to Perform Rate Reviews in 10 States"

Steve Harris (7/21/2011 at 5:53 PM)
Are you aware which states have been identified by CMS for further scrutiny?




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