Kolber Quoted in Modern Healthcare on Insurers Prioritizing Provider Bonuses Over Consumer Rebates

Insurers stretched provider bonuses, quality investment to avoid rebates, CMS says
– Modern Healthcare

Manatt Health Partner Michael Kolber was quoted by Modern Healthcare about a rule recommended by the Centers for Medicare and Medicaid Services (CMS) that aims to impose regulations on how commercial health insurers spend consumers’ premium rebates. Health plans have been giving bonuses to providers in lieu of returning excess profits to patients, according to the article. Kolber stated it's unlikely the rule will slow the growth of “payviders” but instead will add scrutiny to contractual terms between payers and providers, eventually setting a precedent for Medicare and Medicaid programs. "If a plan isn't going to meet its MLR threshold, it has an incentive to find ways to pay its providers more," Kolber said. "When we talk about bending the cost curve and trying to make health costs more sustainable, it really doesn't do anything to that." 

Modern Healthcare subscribers can read the full article here.  



pursuant to New York DR 2-101(f)

© 2022 Manatt, Phelps & Phillips, LLP.

All rights reserved