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HHS/OCIIO RIN: 0950-AA03 Publication ID: Fall 2010 
Title: ●Rate Review 
Abstract: The Affordable Care Act requires the Secretary to work with states to establish an annual review of unreasonable rate increases, to monitor premium increases and to award grants to states to carry out their rate review process. This interim final rule would implement the rate review process. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: Yes  Unfunded Mandates: Undetermined 
EO 13771 Designation: uncollected 
CFR Citation: 45 CFR 154   
Legal Authority: PL 111-148   
Legal Deadline:  None

Statement of Need: The Affordable Care Act requires standards to be set for the review of rate increases. The proposed rule will detail standards for when and how health insurance issuers will be required to report rate increases, as well as detail the relevant data and documentation that must be submitted in support of the rate increases. The proposed rule will detail criteria for how determinations of unreasonableness will be made by HHS, and also sets forth the conditions under which HHS will adopt unreasonableness determinations made by States. This regulation is part of the health insurance market reform and will increase affordability of health insurance for all Americans.

Summary of the Legal Basis: The Affordable Care Act.

Alternatives: There are no alternatives, as this rulemaking is a matter of law based on the Affordable Care Act.

Anticipated Costs and Benefits: HHS expects that costs associated with this rulemaking will be minimal as insurers routinely report to States on rate increases. Insurers may experience slight additional costs in connection with completion of policy rate data collection forms and any necessary submission of justification forms for rates that trigger unreasonable designations. The benefits of these requirements include increased consumer protections around unsubstantiated premium rate increases, reduced health insurance rate increases, increased transparency and consumer confidence in the products they buy, and ensuring financially solvent companies that can pay promised benefits.

Timetable:
Action Date FR Cite
Interim Final Rule  07/03/2010  75 FR 45014   
Interim Final Rule Comment Period End  09/28/2010    
Final Action  12/00/2010    
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: Undetermined 
Federalism: Undetermined 
Included in the Regulatory Plan: Yes 
RIN Data Printed in the FR: No 
Agency Contact:
James Mayhew
Director, Division of Market Rules Compliance Office
Department of Health and Human Services
Office of Consumer Information and Insurance Oversight
Mail Stop C2-12016, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-9244
Email: james.mayhew@cms.hhs.gov