The Department of Health and Human Services releases a list of states and territories with effective rate review programs. According to the final rate review regulation, “States with effective rate review systems will conduct the reviews, but if a State lacks the resources or authority to conduct the required actuarial reviews, HHS will conduct them.” According to a fact sheet on the CCIIO website, “To determine whether a State met these standards, HHS reviewed all available documentation, and met with State regulators and their staff to verify the information and obtain any updates….CMS can reevaluate the status of this list as changes are made in each State.” The states without effective rate review programs in either the individual market or the small group market include: Alabama, Arizona, Idaho, Louisiana, Missouri, Montana and Wyoming. Virginia, Pennsylvania and Iowa have a partial rate review programs; the states have an “effective rate review program” only for the individual insurance market. Rate reviews will begin for increases beginning September 1, 2011 for proposed rates above the applicable threshold (10% from September 2011 to August 2012).