Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 138
Release: 2018-07-05
Genre:
ISBN: 9781722603083

Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordablecare ACT - Program Integrity - Exchange, Shop, and Eligibility Appeals (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordablecare ACT - Program Integrity - Exchange, Shop, and Eligibility Appeals (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 164
Release: 2018-07-05
Genre:
ISBN: 9781722604646

Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State's operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change. This book contains: - The complete text of the Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 138
Release: 2018-11-10
Genre:
ISBN: 9781729722718

Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Exchange and Insurance Market Standards for 2015 and Beyond Cms-9949-F (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Exchange and Insurance Market Standards for 2015 and Beyond Cms-9949-F (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 330
Release: 2018-07-05
Genre:
ISBN: 9781722602581

Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond CMS-9949-F (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond CMS-9949-F (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges ("Exchanges"), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes 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, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; 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; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio (MLR) program. The majority of the provisions in this rule are being finalized as proposed. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond CMS-9949-F (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Market Stabilization (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Market Stabilization (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 76
Release: 2018-07-05
Genre:
ISBN: 9781722602826

Patient Protection and Affordable Care Act - Market Stabilization (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Market Stabilization (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This rule finalizes changes that will help stabilize the individual and small group markets and affirm the traditional role of State regulators. This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Market Stabilization (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - HHS Notice of Benefit and Payment Parameters for 2014 (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - HHS Notice of Benefit and Payment Parameters for 2014 (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 268
Release: 2018-07-05
Genre:
ISBN: 9781722602680

Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally-facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs-risk adjustment, reinsurance, and risk corridors-to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance. This book contains: - The complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 260
Release: 2018-07-05
Genre:
ISBN: 9781722601966

Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters (Cms-9937-F) (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters (Cms-9937-F) (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 302
Release: 2018-07-05
Genre:
ISBN: 9781722601898

Patient Protection and Affordable Care Act - Benefit and Payment Parameters (CMS-9937-F) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (CMS-9937-F) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (CMS-9937-F) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 32
Release: 2018-07-05
Genre:
ISBN: 9781722601829

Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule specifies 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 benefit year 2015. This final rule provides additional flexibility for Exchanges, including the ability to propose unique approaches that meet the specific needs of their state, while streamlining the consumer experience. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section