Regulators last week issued employer-friendly guidance on implementation of the law’s "Summary of Benefits and Coverage” disclosure requirements in the form of “frequently asked questions” (FAQs).

The FAQs clarify, among other things, that:

• SBCs may be provided electronically to participants and beneficiaries in connection with their online enrollment or online renewal of coverage under the plan, expanding the group that may receive SBCs electronically beyond those who can access documents electronically at their worksite. SBCs also may be provided electronically to participants and beneficiaries who request an SBC online.

• Penalties for noncompliance will not be sought where plans are “working diligently and in good faith to comply” in the first year of applicability (coverage beginning before Jan. 1, 2014).

• Regulators are developing a “calculator” that plans can use as a safe harbor for the first year of applicability to complete the coverage examples section in “a streamlined fashion.”

• For group health plans using two or more issuers, regulators will, for enforcement purposes, consider the provision of multiple partial SBCs that together provide all required content to be compliant, as long as participants and beneficiaries are informed and given contact information for additional assistance. For example, separate SBCs could be provided for a group health plan and a carved-out prescription drug plan.

The Departments also issued corrected versions of the official template and completed sample template.

Final MLR rules. Last week also brought final medical loss ratio (MLR) notice regulations. Under the final rules, insurance issuers that meet the MLR requirements must provide a basic notice to subscribers, but only for 2011. The notice must state that the insurer has met the MLR requirements, but it does not have to disclose the actual MLR. Instead, the notice will direct nonrebate recipients to the healthcare.gov website where they can obtain specific MLR information.

CMS proposes higher Medicaid primary care rates. State Medicaid programs and primary care physicians have new proposed guidance from CMS on increased payments to physicians for primary care services provided to Medicaid beneficiaries in 2013 and 2014. Under health care reform, Medicaid must reimburse primary care physicians for these services at rates equal to Medicare fee-for-service rates. The federal government will pick up the cost of this initiative, which is intended to improve access to primary care services in Medicaid in preparation for the program's expansion under the reform law. Comments are due June 11, 2012.

Congressional hearings on tap. This week in Congress, a Senate committee hearing will focus on health system delivery reform amid growing pressure to shift the Medicare program away from its fee-for-service model. A House panel will examine the law’s affect on health care provider consolidation.