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New Medicaid medical-loss ratio won’t strip insurer profits
Modern Healthcare

The federal government is loosely capping the profits of Medicaid managed-care insurers. But many large companies already live within the proposed ratio, raising questions about the regulation’s influence

. Starting in 2017, lump sum rates paid to Medicaid managed-care plans should follow an 85% medical-loss ratio, the CMS said Tuesday. That mark indicates at least 85 cents of every premium dollar must be spent on medical care, while the remaining 15% can go toward administration and profits.