Resources from the Federal Government

CCIIO has released a bulletin on how to verify access to employer-sponsored coverage for the purposes of determining eligibility for advanced premium tax credits (APTCs) through exchanges.

The Centers for Medicare and Medicaid Services (CMS) has released final regulations on The Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 as well as an impact analysis and fact sheet.

This final rule implements standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with the ACA.

This paper, by the United States Department of Health and Human Services, outlines the criteria for state rate reviews.

The final exchange rules released by HHS covers the establishment of exchanges and the eligibility standards for employers. It doesn’t cover exemptions from the individual mandate, essential benefits, or quality standards.

The purpose of this bulletin is to provide information and solicit comments on the regulatory approach that the Department of Health and Human Services (HHS) plans to propose to define actuarial value (AV) for qualified health plans (QHPs) and other non-grandfathered coverage in the individual and small group markets under the ACA.

HHS has released a list of FAQs to provide additional guidance on the administration’s intended approach to defining Essential Health Benefits.

The United States Department of Treasury, Labor, and Health and Human Services have released final rules on the simplified coverage summaries health plans are required to provide under the health reform law.

The Department of Health and Human Services has released updated federal poverty guidelines for 2012, setting the poverty rate at $11,170 in annual income for an individual and at $23,050 in annual income for a family of four.

This guidance letter from the U.S. Departments of Health and Human Services and Agriculture clarifies guidance issued in 2010 on cost-allocation procedures for information technology that can be used to develop health insurance exchanges that are called for under the health care reform law.