Overview of October 24, 2013 Final Rule on Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards

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dc.contributor.authorThe Hilltop Institute
dc.date.accessioned2019-07-09T12:53:24Z
dc.date.available2019-03-14T17:42:02Z
dc.date.issued2013-11-01
dc.descriptionOverview of October 24, 2013 Final Rule on Program Integrity
dc.description.abstractSince the enactment of the Affordable Care Act in 2010, there has been consistent federal guidance employing and clarifying its provisions. Hilltop develops regulation summaries to assist state and local policymakers in their implementation of health reform. On October 24, 2013, the U.S. Department of Health and Human Services (HHS) issued a final rule on Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014. This final rule outlines financial integrity and oversight standards for Exchanges and qualified health plan (QHP) issuers, and the operation of state risk adjustment and reinsurance programs. In addition, this final rule clarifies standards for special enrollment periods, survey vendors that conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in the federally facilitated Exchange (FFE). This document provides a high-level summary of these rules and highlights key changes to the regulation since the issuance of the proposed rule.en_US
dc.description.sponsorship(1) all reinsurance funds received from HHS for reinsurance payments and administrative expenses, (2) all claims for reinsurance payments received from issuers of reinsurance-eligible plans, (3) all reinsurance payments made to issuers of reinsurance-eligible plans, and (4) all administrative expenses incurred for the reinsurance program.en_US
dc.description.urihttps://www.hilltopinstitute.org/wp-content/uploads/publications/Overview-of-the-October-24-2013-Final-Rule-on-Program-Integrity-Exchange-Premium-Stabilization-Programs-and-Market-Standards-pdf.pdfen_US
dc.format.extent23 pagesen_US
dc.genrereportsen_US
dc.identifierdoi:10.13016/m2okcy-eyf4
dc.identifier.urihttp://hdl.handle.net/11603/13061
dc.language.isoen_USen_US
dc.publisherThe Hilltop Instituteen_US
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofThe Hilltop Institute (UMBC) Works
dc.rightsThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.
dc.subjectAffordable Care Act (ACA)en_US
dc.subjectrequirements relating to health insurance coverageen_US
dc.subjectrequirements for the group and individual health insurance marketsen_US
dc.subjectstandards related to reinsuranceen_US
dc.subjectrisk corridorsen_US
dc.subjectrisk adjustmenten_US
dc.subjectexchange establishment standardsen_US
dc.subjecthealth insurance issuer standardsen_US
dc.titleOverview of October 24, 2013 Final Rule on Program Integrity: Exchange, Premium Stabilization Programs, and Market Standardsen_US
dc.typeTexten_US

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