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CMS Announces Temporary System for Paying Insurers for Plans Purchased Through Healthcare.gov
Timothy Jost, in Health Affairs Forefront [Guidance Overview] Dec. 2, 2013 "Insurers that participate in the federal or state exchanges, as well as state exchanges that pay insurers directly, will complete and submit to CMS an enrollment and payment template estimating advance premium tax credit and cost-sharing reduction payments due. The template will include insurer identification numbers, aggregate premium amounts, aggregate advance premium tax credit and cost-sharing reduction payments due, aggregate federal exchange user fees due (which will be offset against payments due the insurer), and aggregate enrollment group and enrollee counts. CMS will validate the data submitted by insurers for reasonableness. Once data are validated, Treasury will make payments to the insurers based on these reports using the Medicare payment system. Finally, CMS will send a payment report detailing plan-level payment amounts to insurers." |
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