Description: By rationing health care resources, managed care organizations have raised ethical and legal issues not commonly found under previous financing structures. This session 95PD of the Palm Desert Spring Meeting addresses these issues. From the Record of the Society of Actuaries, Vol. 23, No. 1.

Description: This discussion from 1977 is an interdisciplinary examination into various methods to control costs under Group Medical Expense coverages. Discussion covers the roles of insurers, employers, health care providers, and the government - and the manner in which they interrelate. From Record of Society of Actuaries, Vol. 3, No. 4.

Description: In this discussion, experts in specific areas reported on recent and current happenings in their field. These include HMOs and manged care, Congressional legislation initiatives, disability insurance and mergers and acquisitions within the health providers/insurers. From Record of Society of Actuaries, Vol. 22, No. 2.

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: This session 110IF of the Las Vegas Spring Meeting updates the changes in the health insurance industry due to recent mergers, acquisitions, and demutualizations. What has the impact of this consolidation been on health products? What is the outlook for continued future consolidations in the health insurance industry? From Record of Society of Actuaries, Volume 26, No 1.

Description: The number of uninsured people in the United States has grown to over 40 million. Many possible solutions have been considered at both the federal and state levels to help alleviate the size and growth of the uninsured population. From the Record of the Society of Actuaries, Volume 27, No. 3, Session 73PD of the New Orleans Annual Meeting.

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: 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.