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November/December 2012 St@teside

HHS Issues a Wave of ACA Rules and Guidance

The U.S. Department of Health and Human Services (HHS) recently released several Affordable Care Act-related guidance and proposed rules. All comments are due on December 26, except for the proposed rule on incentives for nondiscriminatory wellness programs in group health plans. Comments for this specific proposed rule are due on January 25, 2013. Manatt Health Solutions recently provided an analysis of the proposed rules and guidance. Below are the links to the federal documents and the Manatt reviews: 
  • The first proposed rule related to essential health benefits, actuarial value, and plan accreditation: rule and analysis

  • The proposed market reform regulation, covering guaranteed issue, community rating and rate review: regulation and analysis

  • The proposed rules for wellness programs for group health plans: rules and analysis

  • The State Medicaid Director Letter which provides information on the Medicaid benchmark benefits for the new adult group: letter and analysis

  • The OPM rules on multi-state plans: rules and analysis

  • The "HHS Notice of Benefit and Payment Parameters for 2014"  which  covers topics including the federal risk adjustment model, reinsurance parameters, cost-sharing reduction payment methodology, and user fees for insurers offering QHPs in federal exchanges: rules and analysis

It is expected that there will continue to be a flurry of rules and sub-regulatory guidance on ACA provisions in the near future.