{"abstract":"This proposed rule would implement medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program under the Patient Protection and Affordable Care Act.","action":"Proposed rule.","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"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2013/02/22/2013-03921.html","cfr_references":[{"chapter":null,"citation_url":null,"part":422,"title":42},{"chapter":null,"citation_url":null,"part":423,"title":42}],"citation":"78 FR 12428","comment_url":null,"comments_close_on":"2013-04-16","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. EST on April 16, 2013.","disposition_notes":null,"docket_ids":["CMS-4173-P"],"dockets":[],"document_number":"2013-03921","effective_on":null,"end_page":12458,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2013/02/22/2013-03921.xml","html_url":"https://www.federalregister.gov/documents/2013/02/22/2013-03921/medicare-program-medical-loss-ratio-requirements-for-the-medicare-advantage-and-the-medicare","images":{"EP22FE13.003":{"large":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_large.png","medium":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_medium.png","original_size":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_original_size.png"},"EP22FE13.002":{"large":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_large.png","medium":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_medium.png","original_size":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_original_size.png"},"EP22FE13.001":{"large":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_large.png","medium":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_medium.png","original_size":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_original_size.png"},"EP22FE13.000":{"large":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_large.png","medium":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_medium.png","original_size":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_original_size.png"}},"images_metadata":{"EP22FE13.003":{"large":{"identifier":"EP22FE13.003","content_type":"image/png","size":1966,"width":188,"sha":"e231cd21bb97e170399ebdac02d9d3b7","url":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_large.png","height":54},"medium":{"identifier":"EP22FE13.003","content_type":"image/png","size":639,"width":87,"sha":"72873b130c41c1293970220d40ecb6d6","url":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_medium.png","height":25},"original_size":{"identifier":"EP22FE13.003","content_type":"image/png","size":1465,"width":338,"sha":"6f46e00f42dff4d08eaa3937988b54a7","url":"https://img.federalregister.gov/EP22FE13.003/EP22FE13.003_original_size.png","height":97}},"EP22FE13.002":{"large":{"identifier":"EP22FE13.002","content_type":"image/png","size":1340,"width":103,"sha":"721c7496ae89a74b5d448e0804bfbded","url":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_large.png","height":77},"medium":{"identifier":"EP22FE13.002","content_type":"image/png","size":506,"width":49,"sha":"9b482ff6df2850a609ea337806fc424f","url":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_medium.png","height":37},"original_size":{"identifier":"EP22FE13.002","content_type":"image/png","size":991,"width":182,"sha":"9659c31d6c5d2937031403f0b1b65e52","url":"https://img.federalregister.gov/EP22FE13.002/EP22FE13.002_original_size.png","height":136}},"EP22FE13.001":{"large":{"identifier":"EP22FE13.001","content_type":"image/png","size":2276,"width":200,"sha":"dc5f5978f862bc0bac3de3f6a262cdd4","url":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_large.png","height":77},"medium":{"identifier":"EP22FE13.001","content_type":"image/png","size":846,"width":93,"sha":"ab47b83fddac600f8a1eda7e841f814b","url":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_medium.png","height":36},"original_size":{"identifier":"EP22FE13.001","content_type":"image/png","size":1933,"width":361,"sha":"50b274f7fd24d86d373e3d2e9f3a3e0b","url":"https://img.federalregister.gov/EP22FE13.001/EP22FE13.001_original_size.png","height":139}},"EP22FE13.000":{"large":{"identifier":"EP22FE13.000","content_type":"image/png","size":5110,"width":474,"sha":"3ef0fd8a2294472307a54aa5b43209be","url":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_large.png","height":114},"medium":{"identifier":"EP22FE13.000","content_type":"image/png","size":1830,"width":223,"sha":"0f9d35c84f5c5632fdf423efc9fb3724","url":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_medium.png","height":54},"original_size":{"identifier":"EP22FE13.000","content_type":"image/png","size":3764,"width":841,"sha":"7a1eda9e7d6fe1aaf00a7c55b4658a4c","url":"https://img.federalregister.gov/EP22FE13.000/EP22FE13.000_original_size.png","height":203}}},"json_url":"https://www.federalregister.gov/api/v1/documents/2013-03921?publication_date=2013-02-22","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2013-02-22/2013-03921/mods.xml","not_received_for_publication":null,"page_length":31,"page_views":{"count":4872,"last_updated":"2026-10-23 16:15:07 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2013-02-22/pdf/2013-03921.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2013-03921.pdf?1360963028","publication_date":"2013-02-22","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2013/02/22/2013-03921.txt","regulation_id_number_info":{"0938-AR69":null},"regulation_id_numbers":["0938-AR69"],"regulations_dot_gov_info":{"supporting_documents":[],"comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2013-0026","supporting_documents_count":0,"docket_id":"CMS-2013-0026","regulation_id_number":"0938-AR69","title":"Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (CMS-4173-P)","checked_regulationsdotgov_at":"2013-04-18T05:00:35Z"},"regulations_dot_gov_url":null,"significant":null,"signing_date":null,"start_page":12428,"subtype":null,"title":"Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit Programs","toc_doc":"Medical Loss Ratio Requirements for Medicare Advantage and Medicare Prescription Drug Benefit Programs","toc_subject":"Medicare Program:","topics":["Administrative practice and procedure","Emergency medical services","Health facilities","Health maintenance organizations (HMO)","Health professions","Medicare","Penalties","Privacy","Reporting and recordkeeping requirements"],"type":"Proposed Rule","volume":78}