Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

Description: Prescribers, payers, and patients must put a higher priority on the comparative cost-effectiveness of competing pharmaceutical products if society is ever going to achieve rational and affordable drug use for all. From Prescription Drugs Monograph, M-HB04-1.

Description: This article discusses what actuaries see as ideal components of a health care reform package with an emphasis on cost control, efficiency, elimination of fraud and reduction of errors.

Description: Panel discussion on current issues, trends, and methodology in individual disability income insurance, including overinsurance, pricing, financial reporting, as well as efforts by professional associations to address these issues.

Description: The presenters will cover the variation in risk adjustment approaches used across state Medicaid programs and compare them to other Federal programs. Additionally, recent developments, such as the use of OCR to extract data from medical charts for risk adjustment, will be discussed.