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Minimum Medical Loss Ratio for Insurers

Ratio of insurance expenditures used on care as opposed to administrative or other costs. Under ACA insurance companies are required to issue rebates to consumers if too large a share of the expenditures are allocated to costs not directly associated with care (max of 15% for large group plans, max of 20% for individual or small group plans).

Presumptive Eligibility for Medicaid

A provision that allows providers to treat (and be reimbursed for) patients who they presume to be eligible for Medicaid, even if that patient is…