CMS Finalizes Program Integrity Rule for Exchanges
Oct. 28—The Centers for Medicare & Medicaid Services released a final rule outlining financial integrity and oversight standards for the health insurance marketplaces, also known as exchanges.
Key policies addressed in the rule include:
- Oversight of state-operated premium stabilization programs
- Program integrity for advance payments of the premium tax credit and cost-sharing reductions
- Program integrity of state marketplaces
- Oversight of qualified health plan issuers in federally facilitated marketplaces
- Establishment of standards for enrollee satisfaction survey vendors
The final rule also adopts provisions that align risk-corridors calculations with the single-risk pool provision and more. Learn more.
Publication Date: Monday, October 28, 2013