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Text of CMS Proposed Regs: Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance] June 26, 2014 33 pages. Excerpt: "This proposed rule would specify additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, beginning with annual redeterminations for coverage for plan year 2015.... [We] propose that the Exchange may utilize the existing procedure... described in 155.335(b) through (m).... [We also] propose that the Exchange may utilize alternative procedures specified by the Secretary for the applicable plan year.... Third ... we propose that the Exchange may utilize alternative procedures approved by the Secretary based on a showing by the Exchange that the alternative procedures would facilitate continued enrollment in coverage for which the enrollee remains eligible, provide clear information about the process to the qualified individual or enrollee ... and provide adequate program integrity protections.... We solicit comment regarding standards for approving alternative procedures, and on other elements of the annual redetermination process, as well as how it affects renewal for individuals who are enrolled in a QHP through the Exchange." MORE >> |
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