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Archive Tag: Exchanges

CMS Proposes Further Updates for Exchange Health Plans Starting 2022, Including Fees, Enrollment, and 1332 Waivers (CMS-9906-P)

On the evening of June 28, 2021, the Centers for Medicare & Medicaid Services and the Department of the Treasury put a proposed rule on display[1] that includes rules and policies designed to promote greater access to comprehensive health insurance coverage through the Exchanges, consistent with applicable law and recent Presidential executive orders.[2],[3],[4] The proposed [...] Read More

HHS Finalizes Policies for 2020 Exchange Plans

On April 18, 2019, the Department of Health and Human Services (HHS) released the final 2020 notice of benefit and payment parameters. This final rule outlines policies for qualified health plans (QHPs), the exchanges, and navigators. These policies will be effective for the 2020 plan year. HHS Will Allow Plans to Exclude Value of Copay [...] Read More

HHS Proposes More-Frequent Monitoring of Exchange Enrollee Income for Premium Tax Credit, Cost-Sharing Assistance, and Medicaid Eligibility Purposes

The Department of Health and Human Services (HHS) has released a proposed rule that, if finalized, will require federal and state-based Exchanges to conduct more frequent checks to verify enrollee eligibility for premium tax credits, cost-sharing assistance, and Medicaid. Individuals would also be able to authorize Exchanges to automatically terminate coverage once the individual becomes [...] Read More

CMS Releases New Guidance for States Requesting Innovation Waivers

The Centers for Medicare and Medicaid Services (CMS) has released a new guidance for states related to State Innovation Waivers granted under section 1332 of the Affordable Care Act (ACA). With this new guidance, CMS will now refer to these waivers as State Relief and Empowerment Waivers. CMS believes that this new guidance will give [...] Read More

Risk Adjustment Report for 2017 Shows Program Functioning “Smoothly”

CMS has released the risk adjustment summary report for the 2017 benefit year for the individual and small-group markets. The program, included as a permanent fixture of the Affordable Care Act (ACA), is designed to discourage adverse selection by health plans by providing transfer payments to plans with higher-than-expected health care costs. On a summer […]

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States Gain Essential Health Benefit Flexibility in 2020, Individuals Living in Counties with One or No Exchange Plans Eligible for Hardship Exemption

This afternoon, the Department of Health and Human Services released the requirements for qualified health plans (QHPs) offered through the Affordable Care Act’s (ACA’s) Exchanges. Generally, the requirements will apply to plan year 2019; exceptions are noted below.  The rule includes many proposals aimed to reduce burdens on states and grant health plan issuers more […]

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