This sounds like an audit to me.
SEC. 113. INSURANCE RATING RULES.
(a) IN GENERAL.—The premium rate charged for an
insured qualified health benefits plan may not vary except
as follows:(1) STUDY.—The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a study of the large group insured and self-insured employer health care markets. Such study shall examine the following:
A) The types of employers by key characteristics, including size, that purchase insured products versus those that self-insure.
(B) The similarities and differences be7
tween typical insured and self-insured health plans.
(C) The financial solvency and capital reerve levels of employers that self-insure by employer size.
(D) The risk of self-insured employers not being able to pay obligations or otherwise becoming financially insolvent.
(E) The extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and mid size employers to self-insure
“Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
This is what as written and it seems I was correct.
(c) LIMITATION ON PHYSICIANS’ SERVICES INCLUDED IN TARGET GROWTH RATE COMPUTATION TO SERVICES COVERED UNDER PHYSICIAN FEE SCHEDULE.—Effective for services furnished on or after January 1, 2009, section 1848(f)(4)(A) of such Act is amended striking ‘‘(such as clinical’’ and all that follows through ‘‘in a physician’s office’’ and inserting ‘‘for which payment under this part is made under the fee schedule under this section, for services for practitioners described in section 1842(b)(18)(C) on a basis related to such fee schedule, or for services described in section 1861(p) (other than such services when furnished in the facility of a provider of services)’’.”
A study is NOT an audit, I do not care what it sounds like to you. There is no Audit in this bill relating to physicians services.