Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014
other · US Department of Health and Human Services · Rule · Published 2013-03-11 · Effective 2013-04-30 · 78 FR 15410
Document
Document number
2013-04902
Federal Register citation
78 FR 15410
CFR reference
45 CFR 153
Type
Rule
Action
Final rule.
Category
other
Sub-agency
US Department of Health and Human Services
Publication date
2013-03-11
Effective date
2013-04-30
HHS docket
CMS-9964-F
Abstract
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.