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Technical Fact Sheet on HHS Notice of Benefit and Payment Parameters for 2014

On March 12, the Centers for Medicare and Medicaid Services released a Technical Fact Sheet summarizing provisions of the Notice of Benefit and Payment Parameters final rule (the ?Ç£Payment Rule?Ç¥) recently issued by the Department of Health and Human Services (?Ç£HHS?Ç¥). Among other things, the Payment Rule (1) expanded on standards defined in prior rules regarding certain risk-shifting programs under PPACA and (2) set standards and provided additional information regarding PPACA?ÇÖs medical loss ratios.?á See our previous blog post on the Payment Rule, available?áhere.?á A copy of the Technical Fact Sheet is available here

FAQ Regarding Expatriate Health Plans under PPACA

In an FAQ released jointly by the Departments of Labor, Treasury, and Health and Human Services (collectively, the ?Ç£Departments?Ç¥), expatriate health plans are granted temporary transitional relief from compliance with the requirements of subtitles A and C of Title I of the Patient Protection and Affordable Care Act (?Ç£PPACA?Ç¥), including the group health mandates and market reforms such as coverage of preventive care and the restrictions on lifetime and annual limits, for plan years ending on or before December 31, 2015.?á For purposes of this transitional relief, an ?Ç£expatriate health plan?Ç¥ is an insured group health plan with respect to which enrollment is limited to primary-insured individuals who reside outside of their home country for at least six months of the plan year and any covered dependents of such expatriates.?á In order to qualify for the transitional relief, expatriate health plans must comply with the pre-PPACA version of Title XXVII… Continue Reading

March 2013