Last Updated on Tuesday, 17 July 2012 21:47 Written by PNC Washington Correspondent Matt Kaye Tuesday, 17 July 2012 07:35
Guam News - Guam News
Washington D.C. - Congresswoman Madeleine Bordallo is asking the Obama Administration if Guam Health Insurer ‘TakeCare’ can legally avoid rebating $15-million dollars to Guam Insurance consumers.Bordallo says $15-million dollars would go a long way in boosting Guam’s local economy.
HERE Matt Kaye's report HERE>>> 07-17 bordallotakecare.mp3
So she plans on asking Obama Secretary of Health and Human Services Kathleen Sebelius to clarify the application of the so-called “medical loss ratio” that requires rebates for premium overcharges.
The Congresswoman issued a statement in response to questions about ‘TakeCare’s’ decision to use an apparent loophole in the Affordable Healthcare Act to escape paying rebates or premium credits to subscribers.
Bordallo states, “I am asking that Secretary Sebelius clarify the application of medical loss ratio, as well as the capitation provisions to this specific case on Guam.”
Capitation refers to the apparent legal loophole that allows insurers to escape paying rebates by transferring administrative costs to affiliated medical groups, and then count those costs as medical expenses.
The bottom line is that instead of paying $15-million dollars to Guam Insurance subscribers that could go for things like food and fuel, the rebate money’s being recycled to TakeCare’s shareholders.
Bordallo also wants an opinion from Secretary Sebelius on the use of the loophole in Guam. The U.S. Department of Health and Human Services puts the average rebate in Guam at $852-dollars per qualifying family—the highest in the nation.
READ Congresswoman Bordallo's statement on TakeCare in FULL below:
“According to the Department of Health and Human Services, more than $15 million in health insurance rebates would be given back to residents of Guam under the Affordable Care Act. These rebates would create a much needed boost to our local economy. As such, I understand concerns regarding Take Care’s position on the rebates, and I am working to get greater clarification from the Department of Health and Human Services and the Centers for Medicare & Medicaid Services on this matter. I am asking that Secretary Sebelius clarify the application of the medical loss ratio as well as the capitation provisions to this specific case on Guam.”
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