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CMS Starts Implementing ACA Transparency Requirements
Faegre Baker Daniels LLP 
[Guidance Overview] July 28, 2016 "Health insurance issuers will need to submit data on coverage denials, appeals and grievances, and plan decisions overturned by an external reviewer. They will also have to provide links to the member information they provide on several important topics: out-of-network liability, grace periods, medical necessity and prior authorization, and drug formulary exceptions.... While CMS has not yet mentioned its intentions for the transparency data, it is probable that the agency will use this data to inform its oversight activities at some point." MORE >> |
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