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CMS Finalizes Market Stabilization Rule
April 18, 2017, Covington Alert
Last Thursday, the Centers for Medicare & Medicaid Services (CMS) finalized the Affordable Care Act (ACA) market stabilization rule, which it originally proposed in February, 82 Fed. Reg. 10,980 (Feb. 17, 2017). This final rule was published today in the Federal Register and will become effective on June 19, 2017. 82 Fed. Reg. 18,346.
The final rule includes several changes that will be welcome news for insurers, including a tightening of the regulations governing special enrollment periods.
July 3, 2018, Covington Alert
In April, in Common Ground HealthCare Cooperative v. United States, 17-877C (Fed. Cl. April 17, 2018) the Court of Federal Claims granted Common Ground Healthcare Cooperative’s motion for class certification. The certified class includes all insurers offering Qualified Health Plans (QHP) under the ACA for the 2017 or 2018 benefit year that reduced cost-sharing ...
CMS Finalizes Rules Allowing Medicare Advantage Plans To Expand and Target Supplemental Benefits
May 9, 2018, Covington Alert
Under Sections 1852(d) and 1854(c) of the Social Security Act (SSA), a Medicare Advantage (MA) plan must offer uniform benefits, premiums, and cost-sharing within each “segment” in the MA plan’s service area. See 42 C.F.R. § 422.100(d). “Segments” are county-level portions of a plan’s overall service area.
October 13, 2017, Covington Alert
In a court filing this morning and an Executive Order issued yesterday, the Trump Administration announced major policy changes affecting health insurers and employers. The Administration intends to cease making cost-sharing reduction (CSR) payments to insurers, while also expanding the availability of Association Health Plans, short-term health plans, and ...