Regulations

Multiple agencies of the federal government are responsible for developing guidance on enrollment provisions of the Affordable Care Act: the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services, and the Internal Revenue Service at the Department of the Treasury. This guidance includes subregulatory guidance (letters, principles, and papers), which is intended to provide direction to states as they make decisions about health reform implementation, as well as official federal regulations, which states must adhere to as they implement the law. This page will feature links to both kinds of federal guidance, as well as related commentary from Enroll America and other organizations.

Federal Guidance Related to Enrollment

Proposed Rule: HHS Notice of Benefit and Payment Parameters for 2018, Centers for Medicare and Medicaid Services, September 2016 

Proposed Information Collection Activities: Navigators Reporting Requirements in Federally Facilitated and State Partnership Exchanges, Centers for Medicare and Medicaid Services, May 2016

Patient Protection and Affordable Care Act; Amendments to Special Enrollment Periods (SEPs) and the Consumer Operated and Oriented Plan Program, Centers for Medicare and Medicaid Services, May 2016

Draft Updated Federal Standard Renewal and Product Discontinuation Notices, Centers for Medicare & Medicaid Services, April 2016

Agency Information Collection Activities: Proposed Collection; Comment Request, Department of Health and Human Services, December 2015

Final Rule: HHS Notice of Benefit and Payment Parameters for 2017, Centers for Medicare and Medicaid Services, March 2016

Final Rule: Nondiscrimination in Health Programs and Activities, Department of Health and Human Services, May 2016

Final Rule: Coverage of Certain Preventive Services Under the Affordable Care Act, Department of Health and Human Services, Department of the Treasury, Department of Labor, July 2015

Final Rule: Medicaid and Children’s Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions to Third Party Liability, Centers for Medicare & Medicaid Services, Department of Health and Human Services, May 2016

Proposed Rule: Medicaid Program; Mechanized Claims Processing and Information Retrieval Systems, Centers for Medicare and Medicaid Services, April 2015

Proposed Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs, Centers for Medicare and Medicaid Services, March 2015

Proposed Rule: Summary of Benefits and Coverage and Uniform Glossary, Department of the Treasury, Department of Labor, and Department of Health and Human Services, December 2014

Final Rule: HHS Notice of Benefit and Payment Parameters for 2016, Centers for Medicare and Medicaid Services, February 2015

Final Rule: Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards under the Affordable Care Act, Including Standards Related to Exchanges, Centers for Medicare and Medicaid Services, September 2014

Final Standard Notices When Discontinuing or Renewing a Product in the Group or Individual Market, Centers for Medicare and Medicaid Services, September 2014

Final Rule: Exchange and Insurance Market Standards for 2015 and Beyond, Centers for Medicare and Medicaid Services, May 2014

Blueprint for Approval Of Affordable Health Insurance Marketplaces, Centers for Medicare and Medicaid Services, March 2014

Final Rule: Basic Health Program, Health and Human Services, March 2014

HHS Notice of Benefit and Payment Parameters for 2015, Centers for Medicare and Medicaid Services, March 2014

2015 Letter to Issuers in the Federally-facilitated Marketplaces, Centers for Medicare and Medicaid Services, March 2014

CMS Bulletin to Marketplaces on Availability of Retroactive Advance Payments of the PTC and CSRs in 2014 Due to Exceptional Circumstances, Centers for Medicare and Medicaid Services, February 2014

Interim Final Rule: Patient Protection and Affordable Care Act; Maximizing January 1, 2014 Coverage Opportunities, Centers for Medicare and Medicaid Services, December 2013

Final Rule: Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014, Centers for Medicare and Medicaid Services, October 2013

Final Rule: Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors, Health and Human Services, July 2013

Proposed Rule: Standards for Navigators and Non-Navigator Assistance Personnel, Centers for Medicare and Medicaid Services, April 2013

Draft Single Streamlined Application, Centers for Medicare and Medicaid Services, January 2013

Proposed Rules: Medicaid, Children’s Health Insurance Programs, and Exchanges, Centers for Medicare and Medicaid Services, January 2013

Guidance on State Partnership Exchanges, Center for Consumer Information and Insurance Oversight, January 2013

Frequently Asked Questions on Exchanges, Market Reforms, and Medicaid, Centers for Medicare and Medicaid Services, December 10, 2012

Medicaid/CHIP Affordable Care Act Implementation: Answers to Frequently Asked Questions, Centers for Medicare and Medicaid Services, November 19, 2012

Single Streamlined Application Data Elements, Centers for Medicare and Medicaid Services, July 2012

Final Blueprint for Approval of State-based and State/Federal Partnership Insurance Exchanges, Centers for Medicare and Medicaid Services, August 2012

Guidance: Federally-facilitated Exchanges, Centers for Medicare and Medicaid Services, May 2012

Final Rule: Medicaid Eligibility Changes Under the Affordable Care Act, Centers for Medicare and Medicaid Services, March 2012 (Note, several provisions in this rule were issued as interim final.)

Final Rule: Establishment of Exchanges and Exchange Eligibility Determinations, Centers for Medicare and Medicaid Services, March 2012 (Note, several provisions in this rule were issued as interim final.)

Final Rule: Summary of Benefits and Coverage and Uniform Glossary, Department of Treasury, Department of Labor, and Department of Health and Human Services, February 2012

Draft State Exchange Certification Application, Centers for Medicare and Medicaid Services, November 2011 (Also see related notice in the November 10, 2011 edition of the Federal Register.)

Guidance: State Exchange Implementation Questions and Answers, Centers for Medicare and Medicaid Services, November 2011

Proposed Rule: Medicaid Eligibility Changes Under the Affordable Care Act, Centers for Medicare and Medicaid Services, August 2011

Proposed Rule: Exchange Functions in the Individual Market, Eligibility Determinations, and Exchange Standards for Employers, Centers for Medicare and Medicaid Services, August 2011
Proposed Rule on the Health Insurance Premium Tax Credit, Internal Revenue Service, August 2011
Proposed Rule on Establishment of Exchanges and Qualified Health Plans, Centers for Medicare and Medicaid Services, July 2011

Guidance for Exchange and Medicaid Information Technology (IT) Systems, Version 2.0, Centers for Medicare and Medicaid Services, May 2011

Federal Funding for Medicaid Eligibility Determination and Enrollment Activities, Centers for Medicare and Medicaid Services, April 2011

Guidance for Exchange and Medicaid Information Technology (IT) Systems, Version 1.0, Office of Consumer Information and Insurance Oversight and Centers for Medicare and Medicaid Services, November 2010

Section 1561 Recommendations, Office of the National Coordinator for Health Information Technology, September 2010

HIT Policy & Standards Committee Enrollment Workgroup Recommendations, Office of the National Coordinator for Health information Technology, September 2010

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