{"abstract":"This final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to address the treatment of \"mini-med\" and expatriate policies under these regulations for years after 2011; modify the way the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit expenditures; and revise the rules governing the distribution of rebates by issuers in group markets.","action":"Final rule with comment period.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2011/12/07/2011-31289.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"158","title":45}],"citation":"76 FR 76574","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective date. This rule is effective on January 3, 2012.","disposition_notes":null,"docket_ids":["CMS-9998-FC"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":53,"comment_start_date":"2011-12-07","updated_at":"2026-08-05T15:56:42.752-04:00","comment_url":"https://www.regulations.gov/commenton/CMS-2011-0179-0001","allow_late_comments":false,"id":"CMS-2011-0179-0001","comment_end_date":"2012-01-07","regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2011-0179","title":"Medical Loss Ratio Requirements"},{"supporting_documents":[],"agency_name":"HHS","documents":[{"comment_count":0,"comment_start_date":"2011-12-07","updated_at":"2026-08-05T15:56:42.429-04:00","comment_url":"https://www.regulations.gov/commenton/HHS-OS-2022-0008-0334","allow_late_comments":false,"id":"HHS-OS-2022-0008-0334","comment_end_date":null,"regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"HHS-OS-2022-0008","title":"HHS 2022 Archive"}],"document_number":"2011-31289","effective_on":"2012-01-03","end_page":76594,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2011/12/07/2011-31289.xml","html_url":"https://www.federalregister.gov/documents/2011/12/07/2011-31289/medical-loss-ratio-requirements-under-the-patient-protection-and-affordable-care-act","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2011-31289?publication_date=2011-12-07","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2011-12-07/2011-31289/mods.xml","not_received_for_publication":null,"page_length":21,"page_views":{"count":10446,"last_updated":"2026-10-23 16:15:07 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2011-12-07/pdf/2011-31289.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2011-31289.pdf?1322842632","publication_date":"2011-12-07","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2011/12/07/2011-31289.txt","regulation_id_number_info":{"0938-AQ71":{"issue":"201104","html_url":"https://www.federalregister.gov/regulations/0938-AQ71/medical-loss-ratios-cms-9998-f-","title":"Medical Loss Ratios (CMS-9998-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201104&RIN=0938-AQ71&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AQ71"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AQ71/medical-loss-ratios-cms-9998-f-","title":"Medical Loss Ratios (CMS-9998-F)"},"comments_count":53,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2011-0179","supporting_documents_count":0,"docket_id":"CMS-2011-0179","document_id":"CMS-2011-0179-0001","regulation_id_number":"0938-AQ71","title":"Medical Loss Ratio Requirements","checked_regulationsdotgov_at":"2026-08-06T22:55:04Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":76574,"subtype":null,"title":"Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act","toc_doc":"Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act","toc_subject":null,"topics":["Administrative practice and procedure","Claims","Health care","Health insurance","Penalties","Reporting and recordkeeping requirements"],"type":"Rule","volume":76}