The Centers for Medicare & Medicaid Services (CMS) has finalized its Affordable Care Act (ACA) Marketplace health plan payment parameters and essential benefit standards for 2016. The rule addresses numerous policies, including: allocation of risk corridors collections for 2016; recalibration of risk adjustment factors; revisions to reinsurance and cost sharing parameters; user fees for
Small Business Health Options Program (SHOP)
CMS Finalizes ACA Exchange, Insurance Market Standards for 2015 and Beyond
By Debra A. McCurdy on
On May 27, 2014, CMS published a final rule updating ACA Affordable Insurance Exchange and insurance market standards beginning in 2015. Among other things, the rule addresses standards related to: standardized consumer notices regarding insurance product discontinuation and renewal; Qualified Health Plan (QHP) quality data reporting to support quality ratings for plans on the…
Obama Administration Continues to Update ACA Insurance Exchange and Health Plan Regulations
By Debra A. McCurdy on
The Administration has issued numerous regulations recently that make additional changes to operational policies, payment provisions, and other standards applicable to health plans and Health Insurance Exchanges (also called Marketplaces) under the Affordable Care Act (ACA). Highlights include the following:
Continue Reading Obama Administration Continues to Update ACA Insurance Exchange and Health Plan Regulations
CMS Publishes Final ACA Small Business Health Option Program (SHOP) Rule
By Debra A. McCurdy on
On June 4, 2013, CMS published a final rule that builds on and revises previously-adopted regulations on the administration of the ACA’s Small Business Health Options Program (SHOP), which will help small employers offer employees a variety of qualified health plans (QHPs). Specifically, the rule adds changes in eligibility for state premium assistance under…
Reed Smith Alert: ACA Affordable Insurance Exchanges and Qualified Health Plans
By Debra A. McCurdy on
In less than one year, Affordable Insurance Exchanges (“Exchanges”) authorized by the Affordable Care Act (“ACA”) are scheduled to be operational, providing a marketplace for the purchase of Qualified Health Plans (“QHPs”) in the individual and small group markets. The Obama Administration has recently accelerated rulemaking and subregulatory guidance associated with the new Exchange/QHP framework,…