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Text of CMS Manual for Reconciliation of the Cost-Sharing Reduction Component of Advance Payments for Benefit Year 2017 (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]
Mar. 30, 2018
49 pages. "CMS is releasing this final manual to all issuers offering a qualified health plan (QHP) through a health insurance Exchange. The manual provides information on the process for reconciling the cost-sharing reduction component of the advance payments that QHP issuers have been paid through the September 2017 payment cycle against the cost-sharing reduction amounts those issuers provided to eligible Exchange enrollees for the entire 2017 benefit year to determine any charges owed to CMS. The manual also provides QHP issuers with general instructions on using the standard, simplified, and actuarial value (AV) methodologies ... for the purpose of determining the value of cost-sharing reduction amounts provided to eligible Exchange enrollees, and describes the data elements issuers are required to submit when the annual cost-sharing reduction reconciliation process begins April 2, 2018."

Final CSR Reconciliation Issuer to MIDAS package for Benefit Year 2017 and Benefit Year 2016 Restatements also includes:

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