ACA Offers Rate Review Grants – June 2014

The Obama administration is issuing a fourth round of health plan rate review grant monies to state insurance departments.  All 50 states including the District of Columbia and six territories can apply for the grants.  

These grants may be used to acquire the legal authority to review rate changes, to expand the scope of existing rate review operations, to make rate information available to the public through the internet, and to examine medical claims reimbursement data, according to the Center for Consumer Information & Insurance Oversight (CCIIO) officials.
 
Grants awarded will range from $719,643 dollars to a maximum of $5 million dollars, and applications are due July 21st, 2014.

The ACA required CCIIO’s parent, the U.S. Department of Health and Human Services (HHS), to help improve state health insurance rate review programs.  HHS established regulations that require state insurance departments or another entity to review any requests for increases of 10 percent or higher.  And HHS does not require reviews of requests for large rate decreases.

Since the inception of the ACA, in 2010, HHS awarded a total of $46 million in ACA rate review program grants to 45 states and the District of Columbia.  HHS handed out rate review grants in three phases in 2011. That year, 29 states shared $109 million in Phase I grants; one state and three territories shared $8 million in Phase II grants; and one state received $2 million in Phase III grants.
 
In 2013, HHS gave about $68 million in rate review grants to 20 states and one territory.  This year, 15 states are using rate review grants to establish or improve health rate data centers.  We are hopeful more states will continue to take advantage of this federal funding in order to improve the rate review process.

As always, please contact our government relations team with any questions, by phone: (586) 393-8800 ext. 401 or by email: bbochniak@michbusiness.org.