Last week the Legislature passed, and the Governor signed into law, legislation  requiring health insurance plans to get from the Insurance Department prior approval on rates for small group plans and sets a medical loss ratio (MLR) standard of 82 for these plans (see S.8088/A.11369).  Included in the Governor’s budget “extender” bills, the proposal claims to produce state savings that would offset deeper Medicaid cuts. The bill is effective immediately and requires plans to get prior approval from the Insurance Department on plans in the current year.

In addition, an autism coverage mandate bill moved quickly this week through committee to unanimous passage on the Senate floor. See S.7000-B (Breslin)/A.10372-A (Morelle). The bill has been the subject of intense lobbying from advocacy groups interested in having broad-based coverage for a variety of therapies and treatments not typically considered health care, and not all based on sound clinically proven, evidence based medicine. The Business Council opposes this coverage mandate bill, as it lacks some of the standards set in other states with mandatory autism coverage requirements and does little to coordinate between education funding and health care requirements. More broadly, with weak definitions of habilitative care, the coverage mandate has the potential to categorize certain types of services as health care, when in fact it is not related to a legitimate health care expense. Legislative sponsors acknowledge this bill will likely increase premiums by at least 2 percent.