The Obama Administration has recently published additional regulations addressing various Affordable Care Act (ACA) insurance reforms, including:
- A CMS final rule establishing requirements for student health insurance policies offered by college and universities. The rule clarifies that such student policies are subject to certain ACA consumer protections, including a prohibition on lifetime dollar caps on coverage, patients’ bill of rights protections, and compliance with medical loss ratio rules. The rule also sets minimum annual dollar limits on essential health benefits (to be phased in) and enhances transparency provisions. The rule generally applies to student health insurance coverage for policy years beginning on or after July 1, 2012.
- A CMS interim final rule that codifies a variety of ACA policies related to Medicaid and CHIP, including provisions regarding eligibility, enrollment, and coordination with cost-sharing reductions for coverage offered through ACA Affordable Insurance Exchanges (Exchanges). The rule is effective January 1, 2014.
- A CMS notice on the Early Retiree Reinsurance Program (ERRP), notifying plan sponsors participating in the ERRP to use reimbursement funds as soon as possible, but not later than December 31, 2014.
- A Department of Health and Human Services (HHS) final rule establishing ACA standards for states related to reinsurance and risk adjustment, along with requirements for health insurance issuers related to reinsurance, risk corridors, and risk adjustment. These provisions are intended to mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and Exchanges are implemented in 2014. The rule is effective May 22, 2012.
- An HHS advanced notice of proposed rulemaking addresses alternative ways for religious organization that object to the coverage of contraceptive services for religious reasons and are not exempt under the final regulations published February 15, 2012 to fulfill requirements that insurance plans cover preventive services including contraceptives without cost sharing. Comments are due by June 19, 2012.