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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.

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Regulatory Compliance, Healthcare Policy 17 Jan 2025 compliance, healthcare, regulations, administrative practice and procedure, reporting and recordkeeping requirements, disability benefits, aged, blind, social security, musculoskeletal disorders, telehealth, public assistance programs, supplemental security income (ssi)

🏥Extension of Flexibility in Evaluating Healthcare Claims to 2029

We are extending the flexibility in the "close proximity of time" standard, as defined in two prior temporary final rules (TFR), through May 11, 2029. We issued a TFR providing the "close proximity of time" flexibility on July 23, 2021, because the COVID-19 national public health emergency (PHE) caused many individuals to experience barriers that prevented them from timely accessing in-person healthcare. On September 29, 2023, we extended the flexibility to evaluate evolving healthcare practices and consumption in a post-PHE environment. We determined that we need additional time to fully evaluate still-evolving healthcare practices after the PHE. We are therefore issuing this TFR to extend the "close proximity of time" flexibility until May 11, 2029, so we can continue to evaluate changes in healthcare practices and determine the proper "close proximity of time" standard for the musculoskeletal disorders listings.

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