Comments for the Federal Register about Regulations in the Affordable Care Act

ACA-Comments2013 This page features comments from First Focus submitted to the Federal Register regarding regulations of the Affordable Care Act.

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Data Collection and Application for Individuals for Medicaid, CHIP, Exchange, and Employers and Employees in the Small Business Health Option Program (CMS-10440)
Issued January 25, 2013

Centers for Medicare and Medicaid Services (CMS)

Summary: The Affordable Care Act directs the Secretary of Health and Human Services to develop and provide to each State a single, streamlined form that may be used to apply for coverage through the Exchange and Insurance Affordability Programs, including APTC/CSR, Medicaid, CHIP, and the Basic Health Program, if applicable.

Read the First Focus comments here.
Read the group comments here.
Read the group (National Health Care for the Homeless Council) comments here.

Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing
Issued January 22, 2013

Read the regulation details here.

Centers for Medicare Medicaid Services (CMS)
42 CFR Parts 430, 431, 435, and 457
RIN: 0938-AR04

Summary: This proposed rule would implement provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act), and the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This proposed rule reflects new statutory eligibility provisions; proposes changes to provide states more flexibility to coordinate Medicaid and the Children’s Health Insurance Program (CHIP) eligibility notices, appeals, and other related administrative procedures with similar procedures used by other health coverage programs authorized under the Affordable Care Act; modernizes and streamlines existing rules, eliminates obsolete rules, and updates provisions to reflect Medicaid eligibility pathways; revises the rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; implements other CHIPRA eligibility-related provisions, including eligibility for newborns whose mothers were eligible for and receiving Medicaid or CHIP coverage at the time of birth; amends certain provisions included in the “State Flexibility for Medicaid Benefit Packages” final rule published on April 30, 2010; and implements specific provisions including eligibility appeals, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also proposes to update and simplify the complex Medicaid premiums and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities.

Read the First Focus comments here.
Read the First Focus comments here.
Read the group comments here.

Patient Protection and Affordable Care Act: Establishment of Multi-State Plan Program
Issued December 5, 2012

Read the regulation details here.

U.S. Office of Personnel Management
45 CFR Part 800
RIN 3206-AM47

Summary: The U.S. Office of Personnel Management (OPM) seeks comments on a proposed rule to implement the MultiState Plan Program (MSPP). OPM is establishing the MSPP pursuant to the Patient Protection and Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). Under the law, an MSPP issuer may phase in the States in which it offers coverage over four years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP.

Incentives for Nondiscriminatory Wellness Programs in Group Health Plans
Issued November 26, 2012

Read the regulation details here.

U.S. Department of Labor
U.S. Department of Health and Human Services

77 FR 70619

Summary: HHS and the Department of Labor seek comments on proposed rules regarding nondiscriminatory wellness programs in group health coverage. Specifically, these proposed regulations would increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 20 percent to 30 percent of the cost of coverage. The proposed regulations would further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other proposed clarifications regarding the reasonable design of health contingent wellness programs and the reasonable alternatives they must offer in order to avoid prohibited discrimination.

Read the group comments here.

Rule: Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation
Issued November 26, 2012

Read the regulation details here.

Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
45 CFR Parts 147, 155, and 156
[CMS-9880-P]

Summary: This proposed rule details standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this proposed rule outlines Exchange and issues standards related to coverage of essential health benefits and actuarial value. This proposed rule also
proposes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges.

Read the group comments here.

Pre-Existing Condition Insurance Plan Program
Issued August 30, 2012

Read the regulation details here.

Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
45 CFR Parts 147, 155, and 156
[CMS-9880-P]

Summary: HHS is asking for comments on an amendment regarding program eligibility to the interim final regulation implementing the Pre-Existing Condition Plan (PCIP) program under provisions of the ACA. The amendment prevents teenagers and young adults who are granted deferred action through Deferred Action for Childhood Arrivals (DACA) program from being eligible for the ACA’s federally funded PCIP, buying health insurance in the Exchange, or from accessing the premium tax credits.

Read the First Focus comments here.

Solicitation of Public Input on Conversion of Net Income Standards to Equivalent Modified Adjusted Gross Income Standards
Issued June 21, 2012

Comments for the Federal Register about Regulations in the Affordable Care Act

Lisa Shapiro

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