New HHS rule seeks private insurance transparency

The U.S. Department of Health and Human Services (HHS) is reminding health insurers seeking to increase their rates by 10 percent or more that they must submit their request to state or federal reviewers to determine whether they are reasonable or not. This rate review program, created by the Patient Protection and Affordable Care Act, will help to bring greater transparency and accountability for families and small business owners.

In an increasing number of states, regulators now have the authority to deny or reduce rate hikes found to be excessive, according to HHS. Insurers that insist on going ahead with double-digit rate increases are required to post their justifications on their website, and state and federal regulators will post them as well.

Insurers proposing double-digit increases will have to provide clear information that indicates what factors are causing proposed increases. Experts will closely examine information about the underlying cost trends in healthcare to flag instances when insurance companies are unjustly raising costs, remarked the HHS.

Starting mid-September, consumers in every state can go to HealthCare.gov to view disclosure information explaining proposed increases that are 10 percent or higher than last year’s rates.

The HHS said that consumers will see a summary of the factors driving rate increases and an explanation provided by insurance companies for why the proposed increase is needed. For the first time, consumers in every state also will be given the ability to comment on large proposed rate increases.