Proposed rule impacts health insurer operations
A proposed rule would implement several changes in how health insurers operate under the Patient Protection and Affordable Care Act (PPACA). Issued by the Centers for Medicare & Medicaid Services (CMS), the rule will be published in the Federal Register on Dec. 7.
The rule is one of the major components supporting the state health insurance exchanges expected to be operational by October 2013, although that date may be delayed.
The rule covers risk adjustment, reinsurance and risk corridors programs to stabilize premiums; cost-sharing reductions and advance payments of the premium tax credit to assist low- and moderate-income consumers in affording coverage via an exchange; user fees levied on payers to support the exchanges; the Small Business Health Option Program to increase insurance options; and the medical loss ratio program to control insurer administrative costs.
The permanent risk adjustment, reinsurance and risk corridor programs provisions in the proposed rule “fill in the framework established by the Premium Stabilization Rule” that was finalized in March, according to CMS. Overall, “the provisions of this proposed rule, combined with other provisions in PPACA, will improve the individual insurance market by making insurance more affordable and accessible to millions of Americans who currently do not have affordable options available to them,” CMS contends in the proposed rule.
Read the proposed rule.
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.