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HHS Issues Additional Insurance-Related ACA Regulations




This week in Washington—HHS released additional insurance-related ACA regulations. You are tuning in to the National Association of Public Hospitals and Health Systems health policy update for the week of March 4, 2013.

As states and the federal government work toward Affordable Care Act (ACA) implementation deadlines, the U.S. Department of Health and Human Services (HHS) released on March 1 a number of regulations clarifying ACA-related insurance provisions. HHS released a final rule that addresses the ACA-created risk adjustment, reinsurance and risk corridor programs. The rule also finalizes HHS’ proposal to make advance payments that total the value of cost-sharing reductions, as well as the mechanisms for determining the amount of the advance payment for the premium tax credit to issuers on behalf of eligible individuals.

HHS also released a proposed rule that outlines a transitional policy for certain operations of the small business health options program (SHOP) to ensure market stability in 2014 and conform enrollment periods to those in the broader insurance market. Lastly, HHS released an interim final rule adjusting the risk corridors calculation to align with the single risk pool provision of the ACA, and allowing qualified health plans to use an optional simplified methodology to calculate cost-sharing reductions for a transition period.

Meanwhile, the federal Office of Personnel Management (OPM) issued a final rule on March 1 that established standards for the Multi-State Plan Program. Through contracts with OPM, health insurance issuers will offer at least two multi-state plans on each of the health insurance exchanges, of which one must be non-profit. These regulations will be published on March 11 in the Federal Register. Comments on the SHOP proposed rule are due, and the final rules will take effect, on May 9.

Thanks for listening to another edition of This Week in Washington. I’m Zina Gontscharow; join us next week for another update.



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