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: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits.

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.

Description: Actuary Dave Dillon describes his role volunteering his time as a teacher in higher education, including the rewards and challenges that teaching offers. He discusses the importance of being attentive to his audience’s pre-existing knowledge and adapting his presentations accordingly. His work as a teacher typically encompasses three distinct domains: 1) acquainting young students with the actuarial profession, 2) educating non-actuaries about public policy issues related to health insurance (including the Affordable Care Act), and 3) instructing current actuaries on advanced methodologies and principles within the field. Recently he taught a health insurance course for actuarial science graduate students at Georgia State University and lectured at Boise State University’s master's program in Population & Health Systems Management. In every teaching and mentoring opportunity, actuaries can contribute to the expansion and prosperity of the profession and are encouraged to pursue these endeavors.