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Focus on Regulation

Tag Archives: Essential Health Benefits

CMS Releases Medicaid Health Reform Final Rule

On July 5, 2013, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final rule, implementing provisions of the Patient Protection and Affordable Care Act (ACA) and the Children’s Health Insurance Program Reauthorization Act.  This rule finalizes provisions of the proposed rule, entitled “Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair

HHS Finalizes Technical Parameters for Premium Tax Credits, Cost-Sharing Reductions and Other Benefits and Payments Related to Qualified Health Plans and the Exchanges

The final Notice of Benefit and Payment Parameters for 2014, issued on March 1, 2013, establishes the final standards for a number of policies and programs that implement the Affordable Care Act’s reforms to private individual and small group health insurance markets in 2014. These policies are designed to make health insurance more affordable for

CMS Releases Final Rule on Essential Health Benefits

On February 20, 2013, the Centers for Medicare and Medicaid Services (CMS) released a final rule providing detailed standards for the essential health benefits (EHB) package as well as actuarial value requirements for plans that must offer EHB. The final rule also addresses the process for entities to become recognized accrediting entities for issuers of

OPM Releases Proposed Approach to Multi-State Plans

On November 30, 2012, the Office of Personnel Management (OPM) released a proposed rule in which the agency set forth the process through which it will establish the Multi-State Plan Program (MSPP), and the standards and requirements for both issuers and plans in the MSPP. In an effort to enhance competition among plans offered through

HHS Issues Proposed Rule Defining Essential Health Benefits Package and Actuarial Value for Health Plans

On November 20, 2012, the Department of Health and Human Services (HHS) issued a much-anticipated proposed rule providing detailed standards for the essential health benefits package as well as actuarial value requirements for plans that must offer essential health benefits. Under the Patient Protection and Affordable Care Act (ACA), the “essential health benefits” (EHB) are

CMS Releases Additional Information Regarding the Benchmark Plans to be Used in Defining the Essential Health Benefits

CMS’ Center for Consumer Information and Insurance Oversight (CCIIO) posted a document entitled “Essential Health Benefits: List of the Largest Three Small Group Products by State” on its website on July 2, 2012.  Beginning in 2014, non-grandfathered plans in the individual and small group markets offered both inside and outside of the state health insurance