HHS and IRS release NPRMs on exchange eligibility, tax credits, medicaid expansion

Posted on August 12, 2011 | No Comments
Filed under Centers for Medicare & Medicaid Services, Department of Health and Human Services, Department of the Treasury, Health Insurance, Internal Revenue Service, Key Developments, Medicaid and CHIP, Rulemaking, Rules, and Guidance, Tax Policy

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The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have released Notices of Proposed Rulemaking (NPRM) on Exchange eligibility and insurance premium tax credits, respectively. Additionally, the Centers for Medicare and Medicaid Services (CMS) has released an NPRM related to the Medicaid eligibility expansion authorized by the Affordable Care Act (ACA).

All three NPRMs are designed to simplify Exchange eligibility and enrollment by coordinating with state Medicaid agencies and the IRS to determine eligibility for premium tax credits and Medicaid under the new expanded eligibility rules laid out in the ACA. Also addressed in the proposed rules is the eligibility and calculation of tax credits for small businesses.

For more information on the Medicaid eligibility expansion, click here. For more information on tax credits, click here. For more information on Exchange eligibility, click here. Finally, for more information on tax credits for small businesses, click here.

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Treasury issues final rules on premium tax credits

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HHS releases final rule on Medicaid eligibility

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Report estimates impact of small business tax credit

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Update: Exchanges Establishment and Eligibility Final Rule

April 10, 2012

The Department of Health and Human Services (HHS), Center for Medicare and Medicaid Services (CMS) has issued a final rule^[1] addressing two previous proposed rules: “Establishment of Exchanges and Qualified Health Plans”^[2] and “Exchange Functions in the Individual Market: Eligibility Determinations and Exchange Standards for Employers.”^[3] The final rule addresses 1) minimum federal standards that States must meet to establish and operate exchanges, 2) the minimum standards that health insurance issuers must meet as Qualified Health Plans (QHPs), and 3) basic standards employers must meet to participate in the Small Business Health Options Program (SHOP) Exchange. CMS indicates that certain portions of the rule will be considered interim final, and the agency will accept comments on certain sections.^[4] CMS also indicates in the Preamble that additional details will be made available in future guidance and rulemaking, where appropriate. For information on the proposed rules, click here. This Update describes major changes made by CMS in the final rule.

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March 23, 2012

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