Pub. L. 111-152, tit. I, subtit. B, sec. 1103 (as amended)

SAVINGS FROM LIMITS ON MA PLAN ADMINISTRATIVE COSTS.

Year: 2010Length: 159 wordsOfficial source
SEC. 1103. SAVINGS FROM LIMITS ON MA PLAN ADMINISTRATIVE COSTS. Section 1857(e) of the Social Security Act (42 U.S.C. 1395w-27(e)) is amended by adding at the end the following new paragraph: โ€œ(4) Requirement for minimum medical loss ratio.โ€”If the Secretary determines for a contract year (beginning with 2014) that an MA plan has failed to have a medical loss ratio of at least .85โ€” โ€œ(A) the MA plan shall remit to the Secretary an amount equal to the product ofโ€” โ€œ(i) the total revenue of the MA plan under this part for the contract year; and โ€œ(ii) the difference between .85 and the medical loss ratio; โ€œ(B) for 3 consecutive contract years, the Secretary shall not permit the enrollment of new enrollees under the plan for coverage during the second succeeding contract year; and โ€œ(C) the Secretary shall terminate the plan contract if the plan fails to have such a medical loss ratio for 5 consecutive contract years.โ€ .
Pub. L. 111-152, tit. I, subtit. B, sec. 1103 (as amended): SAVINGS FROM LIMITS ON MA PLAN ADMINISTRATIVE COSTS. | Justis AI