Insurance Market Reform

This policy brief by AHIP examines trends in enrollment and Medicaid health plan participation in state Medicaid programs as well as trends in other types of Medicaid managed care, and describes how Medicaid health plans are working with states to address ongoing fiscal challenges.

According to the Government Accountability Office (GAO) report, the Center for Consumer Information and Insurance Oversight (CCIIO) received a total of 1,415 applications for waivers on restrictions of annual limits on health benefits as of April 25, 2011.

The Medicaid and CHIP Payment and Access Commission released their June report that presents a baseline description of managed care in Medicaid.

The report analyzes data regarding the level of commissions to brokers and "identifies options to modify MLR definitions, methodology and/or numerical standards that may be necessary to protect health insurance consumers, and to preserve the important role of producers in the health insurance transaction and in the resolution of disputed health insurance claims."

On May 26, 2011 Governor Bev Perdue signed into law H.B. 578, which amended previously enacted S.B. 323, measures that will transfer oversight of the state health plan from the Legislature to the state Treasurer's Office, and implement a number of other changes aimed at cost savings.