2/19/2013

A CMS rule proposed Friday lays out medical loss ratio requirements for Medicare plans under the Affordable Care Act. Medicare Part D and Medicare Advantage plans must spend 85% of revenue on quality improvements, prescription drugs, clinical services and other clear patient benefits, the CMS said. Plans that fail to meet the requirements would see enrollment sanctions after three years in a row, and contracts would be terminated after failing to meet requirements for five consecutive years.

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