[PDF] Medical Loss Ratio Requirements Under The Patient Protection And Affordable Care Act Us Department Of Health And Human Services Regulation Hhs 2018 Edition eBook

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 46 pages
File Size : 30,99 MB
Release : 2018-11-09
Category :
ISBN : 9781729716410

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Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to address the treatment of "mini-med" and expatriate policies under these regulations for years after 2011; modify the way the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit expenditures; and revise the rules governing the distribution of rebates by issuers in group markets. This book contains: - The complete text of the Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 120 pages
File Size : 21,59 MB
Release : 2018-11-08
Category :
ISBN : 9781729705407

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Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This document contains the interim final regulation implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act). This book contains: - The complete text of the Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under Patient Protection and Affordable Care Act (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 260 pages
File Size : 22,99 MB
Release : 2018-11-10
Category :
ISBN : 9781729722404

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Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 282 pages
File Size : 43,65 MB
Release : 2018-11-10
Category :
ISBN : 9781729722527

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Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs; cost-sharing parameters; and user fees for Federally-facilitated Exchanges and State Exchanges on the Federal platform. It finalizes changes that provide additional flexibility to States to apply the definition of essential health benefits (EHB) to their markets, enhance the role of States regarding the certification of qualified health plans (QHPs); and provide States with additional flexibility in the operation and establishment of Exchanges, including the Small Business Health Options Program (SHOP) Exchanges. It includes changes to standards related to Exchanges; the required functions of the SHOPs; actuarial value for stand-alone dental plans; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions; and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 268 pages
File Size : 18,66 MB
Release : 2018-11-10
Category :
ISBN : 9781729722640

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Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally-facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs-risk adjustment, reinsurance, and risk corridors-to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance. This book contains: - The complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 242 pages
File Size : 23,93 MB
Release : 2018-11-10
Category :
ISBN : 9781729722572

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Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges ("Exchanges"), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio (MLR) program. The majority of the provisions in this rule are being finalized as proposed. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Exchange and Insurance Market Standards for 2015 and Beyond (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 250 pages
File Size : 32,84 MB
Release : 2018-11-10
Category :
ISBN : 9781729722503

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Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : American Dental Association
Publisher : American Dental Association
Page : 60 pages
File Size : 14,17 MB
Release : 2017-05-24
Category : Medical
ISBN : 1941807712

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Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 78 pages
File Size : 33,52 MB
Release : 2018-11-10
Category :
ISBN : 9781729722671

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Patient Protection and Affordable Care Act - Miscellaneous Minimum Essential Coverage Provisions (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Miscellaneous Minimum Essential Coverage Provisions (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule implements certain functions of the Affordable Insurance Exchanges ("Exchanges"). These specific statutory functions include determining eligibility for and granting certificates of exemption from the individual shared responsibility payment described in section 5000A of the Internal Revenue Code. Additionally, this final rule implements the responsibilities of the Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, to designate other health benefits coverage as minimum essential coverage by providing that certain coverage be designated as minimum essential coverage. It also outlines substantive and procedural requirements that other types of individual coverage must fulfill in order to be certified as minimum essential coverage. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Miscellaneous Minimum Essential Coverage Provisions (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
Page : 82 pages
File Size : 33,58 MB
Release : 2018-11-10
Category :
ISBN : 9781729722657

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Patient Protection and Affordable Care Act - Health Insurance Market Rules - Rate Review (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Health Insurance Market Rules - Rate Review (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, 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. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS). This book contains: - The complete text of the Patient Protection and Affordable Care Act - Health Insurance Market Rules - Rate Review (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section