These final regulations provide guidance on the interpretation and application of section 833(c)(5).
They guide certain health care organizations in computing and applying the medical loss ratio added to the Code by the Patient Protection and Affordable Care Act.
This notice advises taxpayers that certain payments received by an individual care provider under a state Medicaid Home and Community-Based Services Waiver program are difficulty of care payments excludable from gross income under § 131 of the Code.
The exclusion may apply whether the care provider is related or unrelated to the individual receiving care.
This document contains final amendments to 26 CFR part 1 (Income Tax Regulations) under section 833(c)(5).
Section 833(c)(5) was added to the Code by section 9016 of the Patient Protection and Affordable Care Act (Affordable Care Act), Public Law 111–148 (124 Stat.
For purposes of section 833, an organization’s MLR is its percentage of total premium revenue expended on reimbursement for clinical services provided to enrollees under its policies during such taxable year (as reported under section 2718 of the Public Health Service Act (PHSA)).