Proposed Rule 19 Mar 2025 compliance, healthcare, regulation, consumer protection, administrative practice and procedure, reporting and recordkeeping requirements, sunshine act, intergovernmental relations, health care, conflict of interests, indians, medicaid, youth, civil rights, insurance, brokers, health records, health insurance, hospitals, technical assistance, individuals with disabilities, aged, organization and functions (government agencies), advertising, grant programs-health, taxes, sex discrimination, citizenship and naturalization, advisory committees, public assistance programs, grants administration, women, loan programs-health, state and local governments, enrollment, premium payments, health maintenance organizations (hmo), aca

🏥Proposed Rule for Marketplace Integrity Under the ACA

This proposed rule would revise standards relating to past-due premium payments; exclude Deferred Action for Childhood Arrivals recipients from the definition of "lawfully present"; the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; failure to file and reconcile; income eligibility verifications for premium tax credits and cost-sharing reductions; annual eligibility redetermination; the automatic reenrollment hierarchy; the annual open enrollment period; special enrollment periods; de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements and for income-based cost-sharing reduction plan variations; and the premium adjustment percentage methodology; and prohibit issuers of coverage subject to EHB requirements from providing coverage for sex-trait modification as an EHB.

Learn More