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Obama seeks to add teeth to MLR in managed Medicaid overhaul
Modern Healthcare: The finalized rule that will overhaul managed Medicaid is mere weeks away from being released. Ahead of its unveiling, the Obama administration is turning to Congress to add more enforcement "teeth" to a key policy in the rulemaking.The CMS sent a shudder through the insurance industry last year when it suggested that states set a medical-loss ratio (MLR) of 85% for Medicaid plans, meaning at least 85 cents of every premium dollar must be used for medical care. The remainder can go toward administration, marketing and profit.
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