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Key Priorities for Compliance Reviews of Issuers and Plans on Federally-facilitated Marketplaces for the 2014 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] Link to more items from this source
[Official Guidance]
Apr. 14, 2014
"CMS will perform compliance reviews of issuers offering Qualified Health Plans (QHPs) in the Federally-facilitated Marketplaces (FFM). For purposes of this document, QHPs include stand-alone dental plans, unless otherwise indicated.... CMS will review data at both the issuer and the QHP level. Policies, procedures and any other applicable documentation may be requested, as part of the compliance review process, to show compliance with issuer standards. As additional final regulations and operational guidance are published, those standards may be included as part of the compliance reviews ... [T]his list should not be construed as a comprehensive listing of all standards applicable to QHP issuers in the FFMs, nor a limitation on CMS' authority or ability to review compliance with standards not appearing on this list."

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