Half of Medical Loss Reports are Incomplete

The US Office of Inspector General (OIG) announced that nearly half of the medical loss reports (MLR) submitted by Medicare managed care plans were incomplete. The plans are supposed to send reports containing specific information, including data for MLR calculations. As a result, the OIG is calling for more oversight at the state level.

According to , “The incomplete reports were missing at least one of seven numeric data elements required to calculate MLRs. The missing data was related to non-claims costs, taxes and fees, member months, and quality improvement activity expenses. Two-thirds of the incomplete reports did not have fields for plans to enter amounts for at least one of these data elements.”

To read more, click here.

(Source: Health Payer Intelligence, September 27^th, 2022)