Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019
other · US Department of Health and Human Services · Rule · Published 2018-04-17 · Effective 2018-06-18 · 83 FR 16930
Document
Document number
2018-07355
Federal Register citation
83 FR 16930
CFR reference
45 CFR 147
Type
Rule
Action
Final rule.
Category
other
Sub-agency
US Department of Health and Human Services
Publication date
2018-04-17
Effective date
2018-06-18
HHS docket
CMS-9930-F
Abstract
This final rule sets forth payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs; cost-sharing parameters; and user fees for Federally- facilitated Exchanges and State Exchanges on the Federal platform. It finalizes changes that provide additional flexibility to States to apply the definition of essential health benefits (EHB) to their markets, enhance the role of States regarding the certification of qualified health plans (QHPs); and provide States with additional flexibility in the operation and establishment of Exchanges, including the Small Business Health Options Program (SHOP) Exchanges. It includes changes to standards related to Exchanges; the required functions of the SHOPs; actuarial value for stand-alone dental plans; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions; and other related topics.