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Recent CMS Releases: Medicaid and CHIP Enrollment, Data Verification, and Applications for 2015 Qualified Health Plans
Timothy Jost in Health Affairs Forefront
[Guidance Overview] June 10, 2014 "The instructions cover the 13 areas of requirements that QHP applicants must meet, including, for example, licensure, accreditation, actuarial value, network adequacy, prescription drugs, plans and benefits, and others. Also included in the release are rating tables and rating business rules insurers must follow, as well as forms to be used for insurers to provide justifications if issues arise from their application, such as cost sharing or formulary outliers.... [T]he 65-page section on plans and benefits ... sets out the elements that CMS expects will be shown to consumers in 'plan compare' on healthcare.gov for 2015." MORE >> |
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