NAIC to Tell Energy and Commerce Committee It Did Not Receive HHS Influence

The letter also asks whether HHS officials engaged in any communications “with you or any NAIC staff, whether oral or written, which indicated that HHS would refuse to certify in whole or in part the model regulations being considered by the NAIC?”

The letter also asks whether HHS officials provided NAIC commissioners or staff with legal interpretations of activities that may or may not be included within the definition of “activities that improve health care quality,” and “non-claim costs” under provisions of the regulations under attack by the committee.

The NAIC did tell HHS when it was done and what it had done and what was outside its purview. In Oct. 21 2010, the NAIC stated that “in coordination with the anticipated completion of the model regulation, last week the NAIC sent a letter to HHS Secretary Sebelius addressing related issues raised during this summer’s deliberations that were outside the purview of the NAIC’s responsibilities. Issues raised in the letter included: insurer solvency; the flexibility for states to phase in recommendations to reduce market disruptions; the application on expatriate policies; and the methods of paying related rebates to consumers.”

On Nov. 22, the NAIC adopted a resolution urging Congress and HHS to use their respective authorities to preserve consumer access to insurance agents and brokers by adjusting the MLR component of PPACA to accommodate the essential service provided by producers in the health insurance market.

The HHS declined to do so, upsetting many states who say the rule is undermining the individual health insurance market in their states by clobbering agent commissions.

An Energy & Commerce spokeswoman pointed to the remarks in the letter that prompted its inquiry to the NAIC:

“The Energy and Commerce Committee has held multiple hearings at which Administration officials and stakeholders testified regarding the MLR. Several witnesses have given testimony regarding the law’s harmful impacts on jobs in the agent and broker community. We have also heard testimony regarding the negative impacts of the MLR provision on patient choice in health coverage, as well as its deleterious effects on health care quality and the prevention of fraud. With this in mind, we would like to understand the processes behind NAIC’s deliberations on the MLR rule and its decision to recommend the model regulation as drafted.”

The committee has introduced two measures supported by the insurance agents. But the panel appears to be unable to win full committee and full House support for the measures. And, Democrats in the Senate are opposed, according to industry officials, as are insurance commissioners in large states, such as California, Washington and New York.

One is H.R. 1206, which would exclude producer compensation from medical loss ratio calculations. Another is H.R. 2077, which would repeal the MLR entirely.

H.R. 1206, sponsored by Rep. Mike Rogers (R-Mich.) and John Barrow (D-Ga.), has strong support. The bill has 139 co-sponsors. But it has been mired for months in the House.

The HHS did not return an email query.