The Centers for Medicare and Medicaid Services has issued a proposed rule setting financial integrity and oversight standards for qualified health plans operating in state health insurance exchanges under the Affordable Care Act.
Issues tackled under the rule include cost-sharing reductions and advance payments of the premium tax credit, the Small Business Health Options Program, the single risk pool, quality standards, and risk adjustment, reinsurance and risk corridor programs; among others.
The rule also proposes additional standards for agents and brokers, geographic rating areas, guaranteed availability and renewability, special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys for payers, insurers participating in a federally-built exchange in states that declined to build their own, and state operations of a SHOP.
The proposed rule, with a 30-day comment period, is scheduled for publication in the Federal Register on June 19. It is now available here.
Register or login for access to this item and much more
All Health Data Management content is archived after seven days.
Community members receive:
- All recent and archived articles
- Conference offers and updates
- A full menu of enewsletter options
- Web seminars, white papers, ebooks
Already have an account? Log In
Don't have an account? Register for Free Unlimited Access