Final Regulations on ACA Program Integrity

The Centers for Medicare & Medicaid Services issues final rule outlining Exchange standards with respect to eligibility appeals, handling of consumeer complaints and other issues.

Document Excerpt

This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State’s operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change.

 

Link https://www.federalregister.gov/articles/2013/08/30/2013-21338/program-integrity-exchange-shop-and-eligibility-appeals-patient-protection-and-affordable-care-act

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