Description: Report on the findings and recommendations of the work group convened by the Bureau of Insurance to assess issues related to costs affecting Medicare Advantage and Medicare supplement policies, as defined in § 38.2-3600 of the Code of Virginia, and to develop recommendations for regulations issued pursuant to § 38.2-3608 of the Code of Virginia, including a review of (i) current minimum standards for processing and payment of claims under Medicare supplement policies; (ii) the implementation of risk adjustment mechanisms, including the potential use of market stabilization pools for Medicare supplement policies; (iii) ways to eliminate waste and abuse from overpayments; (iv) methodologies used in coverage decisions and the disclosure and reporting practices of insurers related to coverage decisions; (v) ways to improve care under Medicare supplement policies and address disparities in care; and (vi) the effectiveness and utilization of existing consumer protections for individuals under and changing between Medicare supplement policies, including the availability of an annual open enrollment period of 60 days commencing on an individual's birthday, barriers to switching beneficiaries between Medicare supplement policies or carriers, compliance by insurers with applicable guaranteed-issue requirements, and options to improve beneficiary flexibility while maintaining market stability.
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