NAIC Health Insurance and Managed Care Meeting Report: September 10

Sep 11, 2008

On Wednesday, September 10, 2008, the National Association of Insurance Commissioners (“NAIC”) held a Health Insurance and Managed Care Committee (“Committee”) meeting. The agenda included the consideration and adoption of a white paper on the Oversight of Medicare Private Plans and the approval of revisions to the Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act (“Model Act”). To view the complete agenda, click here.

Chairman Joel Ario from Pennsylvania called the meeting to order with a quorum of members in attendance.

Guenther Ruch, an Administrator from the Wisconsin Office of the Commissioner of Insurance introduced the Model Act. The current Model Act revision reflects changes necessitated by passage of the Genetic Information Nondiscrimination Act of 2007-2008 (“GINA”), and changes to the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”). To view the current Model Act version, click here.

GINA prohibits insurance companies from considering genetic information in the setting of rates or writing of policies. Federal regulation standards take effect May 21, 2009; individual states have until July 1, 2009 to adopt the NAIC Model Act, which is expected to be finalized by October 31, 2008.

MIPPA changes add the requirement that if an insurance carrier offers Medicare supplements in addition to the minimum-required Plan A, it must also offer either Plan C or Plan F. These supplemental policies cannot be sold prior to June 8, 2010.

A drafting note explaining a Congressional clarification on guideline conformity has been included in the final Model Act. The drafting note states:

“Under Section104(c) of the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”), policies that are advertised, marketed or designed primarily to cover out-of-pocket costs under Medicare Advantage Plans (established under Medicare Part C) must comply with the Medicare supplement requirements of Section1882(o) of the Social Security Act.”

The Model Act was accepted unanimously by the Committee and next will move to the Plenary Committee for final approval during the NAIC Fall 2008 National Meeting.

In an effort to simplify state regulatory transitions, an informational booklet is being developed to identify all of the recently adopted changes. This booklet is scheduled to be completed in time for dissemination at the Fall Meeting.

The White Paper on the Oversight of Medicare Private Plans was discussed. Drafted by the Medicare Private Plans Subgroup and approved by the Senior Issues Task Force, this White Paper has been designed to offer Congress possible solutions for better oversight from the viewpoint of State regulators and consumers. To view a copy of the White Paper, click here.

The Committee voted to accept the White Paper unanimously.

The meeting was then adjourned.

Should you have any questions or comments, please do not hesitate to contact Colodny Fass.

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