United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2013_register executive 2014-05-29 article Part II Rules and Regulations D09002ee1c7fbd091 D09002ee1c7fbd1a3 United States Department of Health and Human Services originator org United States Government Agency or Subagency This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans. 78 FR 12834 https://www.govinfo.gov/app/details/FR-2013-02-25/2013-04084 2013-04084 fr25fe13-12 RIN 0938-AR03 4120-01-P CMS-9980-F https://www.govinfo.gov/app/details/FR-2013-02-25/2013-04084 https://www.govinfo.gov/content/pkg/FR-2013-02-25/html/2013-04084.htm https://www.govinfo.gov/content/pkg/FR-2013-02-25/pdf/2013-04084.pdf Health Care Health Insurance Reporting and Recordkeeping Requirements State Regulation of Health Insurance Administrative Practice and Procedure Advertising Brokers Conflict of Interest Consumer Protection Grant Programs-Health Grants Administration Health Maintenance Organization (Hmo) Health Records Hospitals Indians Individuals with Disabilities Loan Programs-Health Organization and Functions (Government Agencies) Medicaid Public Assistance Programs Safety State and Local Governments Technical Assistance Women Youth Advisory Committees Sunshine Act 39 p. 12834 12872 78 FR 12834 Title 45 Part 147 45 CFR Part 147 Title 45 Part 155 45 CFR Part 155 Title 45 Part 156 45 CFR Part 156 RIN 0938-AR03 Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation; Federal Register Vol. 78, Issue RULE 2013-04084 II DEPARTMENT OF HEALTH AND HUMAN SERVICES 2013-04-26 CMS-9980-F 4120-01-P 2013-04084 Final rule.

This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

Effective April 26, 2013. Leigha Basini at (301) 492-4307, for general information. Adam Block at (410) 786-1698, for matters related to essential health benefits, actuarial value, and minimum value. Tara Oakman at (301) 492-4253, for matters related to accreditation. Health Care Health Insurance Reporting and Recordkeeping Requirements State Regulation of Health Insurance Administrative Practice and Procedure Advertising Brokers Conflict of Interest Consumer Protection Grant Programs-Health Grants Administration Health Maintenance Organization (Hmo) Health Records Hospitals Indians Individuals with Disabilities Loan Programs-Health Organization and Functions (Government Agencies) Medicaid Public Assistance Programs Safety State and Local Governments Technical Assistance Women Youth Advisory Committees Sunshine Act Patient Protection and Affordable Care Act: Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation , HealthCare.gov http://aspe.hhs.gov/health/reports/2011/AV-ESI/rb.pdf http://aspe.hhs.gov/health/reports/2011/marketcomparison/rb.pdf http://aspe.hhs.gov/health/reports/2011/MarketComparison/rb.shtml http://cciio.cms.gov/resources/data/ehb.html http://cciio.cms.gov/resources/files/ffe-guidance-05-16-2012.pdf http://cciio.cms.gov/resources/files/Files2/02172012/ehb-faq-508.pdf http://cciio.cms.gov/resources/files/Files2/02242012/Av-csr-bulletin.pdf http://cciio.cms.gov/resources/files/Files2/03162012/hie3r-ria-032012.pdf http://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdf http://cciio.cms.gov/resources/files/largest-smgroup-products-7-2-2012.pdf.PDF http://cciio.cms.gov/resources/regulations/index.html#pm http://content.healthaffairs.org/content/early/2012/05/22/hlthaff.2011.1082.full.pdf+html http://www.ahip.org/SurveyHealthCare-January2013 http://www.bls.gov/ncs/ebs/sp/selmedbensreport.pdf http://www.cahi.org/cahi_contents/resources/pdf/MandatesintheStates2010ExecSummary.pdf http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf http://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10449.html http://www.consumersunion.org/pub/pdf/Consumer%20Difficulties%20Selecting%20Health%20Plans%20Jan%202012.pdf http://www.gpo.gov/fdsys/pkg/FR-2012-03-27/pdf/2012-6125.pdf http://www.gpo.gov/fdsys/pkg/FR-2012-07-06/pdf/2012-16508.pdf http://www.gpo.gov/fdsys/pkg/FR-2012-12-05/pdf/2012-29118.pdf http://www.iom.edu/Reports/2011/Essential-Health-Benefits-Balancing-Coverage-and-Cost.aspx http://www.irs.gov/pub/irs-drop/n-12-31.pdf http://www.irs.gov/pub/irs-drop/rp-12-26.pdf http://www.opm.gov/insure/health/planinfo/2012/brochures/FEPBlueVi.pdf http://www.opm.gov/insure/health/planinfo/2012/brochures/MetLife.pdf http://www.sba.gov http://www.statehealthfacts.org/comparereport.jsp?rep=2&cat=7 https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads//Chapter6.pdf www.cciio.cms.gov Vol. 78, no. 37 Office of the Federal Register, National Archives and Records Administration 2013-02-25 continuing daily deposited born digital 352 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2013-02-25 P0b002ee1892c5734 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr25fe13 https://www.govinfo.gov/app/details/FR-2013-02-25 https://www.govinfo.gov/content/pkg/FR-2013-02-25/pdf/FR-2013-02-25.pdf https://www.govinfo.gov/content/pkg/FR-2013-02-25/xml/FR-2013-02-25.xml fdlp 12591 12931 DGPO 2014-05-29 2024-06-03 FR-2013-02-25 machine generated eng FR FR-2013-02-25 78 37