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Final 2015 Letter to Issuers in the Federally-Facilitated Marketplace: Access and Non-Discrimination Considerations
Health Reform GPS Link to more items from this source
[Guidance Overview]
Apr. 9, 2014
"The final letter indicates that CMS will conduct reasonable access reviews, but depending on whether actual network membership does or does not have to be submitted, it is not clear how these reviews will proceed or the standards that the agency will use.... CMS clarifies in the final letter that the agency will limit its oversight to cost sharing design aspects of qualified health plans sold in the exchange Marketplace and will not consider limitations and exclusions, discriminatory benefit definitions, or discriminatory definitions of key over-arching terminology such as the plan's medical necessity definition[.]"

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