HHS: Consumers will get rebates from payors who failed the “80/20 Rule”

The Department of Health and Human Services and the Office of Health Reform today announced that payors who failed to meet the 80/20 Rule will have to give rebates to their customers and disclose the reasons why they didn’t meet the mandate.

The Rule, passed in 2010, requires payors to cover 80 cents out of every premium dollar on medical care and health care quality improvement, rather than on administrative costs.

About 12.8 million people should receive some sort of rebate, said Mike Hash, director of the Office of Health Reform (OHR). Rebates should be sent out by August 1, and could total $1.1 billion.

A list of payors who did not meet the rule is forthcoming, and will be posted on the HealthCare.gov website.

Topics: Executive Leadership , Regulatory Compliance