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Text of CMS Proposed Regs on Exchange and Insurance Market Standards for 2015 and Beyond
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. 16, 2014

279 pages. Excerpt: "[This] rule proposes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program [SHOP], and enforcement remedies in Federally-facilitated Exchanges. It also proposes: [1] a modification of HHS's allocation of reinsurance contributions collected if those contributions do not meet our projections; [2] certain changes to the ceiling on allowable administrative expenses in the risk corridors calculation; [3] modifications to the way we calculate certain cost-sharing parameters so that we round those parameters down to the nearest $50 increment; [4] certain approaches we are considering to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under [Code Section] 5000A; [5] grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; [6] updated standards for the consumer assistance programs; [7] standards related to the opt-out provisions for self-funded, non-Federal governmental plans and the individual market provisions under [HIPAA]; [8] standards for recognition of certain types of foreign group health coverage as minimum essential coverage; [9] amendments to Exchange appeals standards and coverage enrollment and termination standards; and [10] time-limited adjustments to the standards relating to the medical loss ratio program."

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