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CMS Issues Final Rule on Marketplace Subsidies, Oversight

The Centers for Medicare & Medicaid Services (CMS) issued a rule Oct. 24 that finalizes a number of provisions regarding health insurance marketplaces (exchanges). Among these provisions are standards to ensure program integrity around premium tax credit advance payments, cost-sharing reductions, and state marketplaces, including monitoring and reporting standards.

In addition, the final rule outlines how the U.S. Department of Health and Human Services (HHS) will oversee state-operated premium stabilization programs such as the risk adjustment and reinsurance programs that help make marketplace health insurance affordable. The final rule also establishes standards for overseeing issuers offering qualified health plans in the federally run marketplaces and standards for approving vendors to administer enrollee satisfaction surveys to help consumers compare enrollee satisfaction levels among plans.


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