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November 02, 2017
The Centers for Medicare & Medicaid Services is seeking comments on the
proposed
Patient Protection and Affordable Care Act Notice of Benefit and Payment Parameters for 2019.
Comments can be submitted online via Regulations.gov thru
Monday, November 27.
Provisions of particular interest to ACL stakeholders include proposed changes that would:
- enhance the role of states as related to essential health benefits (EHB) and qualified health plan (QHP) certification
- provide states with additional flexibility in the operation and establishment of Exchanges, including the Small Business Health Options Program (SHOP) Exchanges
The proposed rule sets forth payment parameters and provisions related to the risk adjustment programs; cost-sharing parameters and cost sharing reductions; and user fees for federally-facilitated Exchanges and state-based Exchanges on the federal platform.
It also includes proposed changes to standards related to Exchanges; the required functions of the SHOPs; actuarial value for standalone dental plans; the rate review program; the medical loss
ratio program; eligibility and enrollment; exemptions; and other related topics.
View
the federal register notice for the full text of the proposed rule, additional ways to submit comments, and a list of contacts who can provide more information on the proposed rule.
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