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Focus on Regulation

Tag Archives: Qualified Health Plan

HHS: Qualified Health Plans are Not “Federal Health Care Programs”

In a letter to Rep. Jim McDermott, Health and Human Services (HHS) Secretary Kathleen Sebelius answered a question frequently asked by healthcare providers and pharmaceutical and device manufacturers in the roll-up to implementation of the Affordable Care Act: “Are the qualified health plans (QHPs) established through the Act ‘federal health care programs’ under section 1128B

CMS Releases Consumer Assistance Programs Final Rule

The Centers for Medicare & Medicaid Services (CMS) released a final rule on Friday, July 12th imposing requirements on various consumer assistance programs available to enrollees in Federally-Facilitated Exchanges (FFEs), State Partnership Exchanges, and to a more limited extent, State-run Exchanges. The final rule adopted conflict-of-interest, training and certification, and meaningful access standards applicable to

Miscellaneous Minimum Essential Coverage Provisions Final Rule

  The Department of Health and Human Services (“HHS”) released a final rule on June 26, 2013 addressing various aspects of the minimum essential coverage requirements imposed by the Affordable Care Act (“ACA”). Under the ACA, individuals must obtain and maintain health insurance that meets the definition of “minimum essential coverage” or face a tax

HHS Issues Proposed Rule Regarding Program Integrity and the Exchanges

On June 14, 2013, HHS released a Notice of Proposed Rulemaking proposing several new policies with respect to the Exchanges, focusing in large part on program integrity, including with respect to qualified health plans (QHPs) offered through both state-run Exchanges and the Federally-facilitated Exchange (FFE).  The rule also addresses the resolution of certain QHP-related grievances

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 Seeks Comments on Qualified Health Plan Certification Requirements and Exchange Enrollment Forms

Following the Supreme Court’s June 28 decision regarding the Patient Protection and Affordable Care Act (PPACA), CMS has requested comments on the likely burden of the following four proposed data collection activities, each of which pertains to the health insurance exchanges to be established by 2014.  These data collection requirements are imposed on Exchanges, employees,