The Hilltop Institute
Picture of The Hilltop Institute's building (Sondheim Hall) and the Commons at UMBC.
Link to UMBC HomepageHospital Community Benefit Program
  Home >> Publications

Link to Home Page

Link to About Us

Link to Areas of Expertise

Link to Services

Link to Symposia and Meetings

Link to News and Bulletins

Link to Staff

Link to Research and Career Opportunities

Link to Publications and Presentations

Link to Resources and Links

Link to Contact Us

Overview of the October 24, 2013 Final Rule on Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards

November 01, 2013

Since the enactment of the Affordable Care Act in 2010, there has been consistent federal guidance employing and clarifying its provisions. Hilltop develops regulation summaries to assist state and local policymakers in their implementation of health reform. On October 24, 2013, the U.S. Department of Health and Human Services (HHS) issued a final rule on Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014. This final rule outlines financial integrity and oversight standards for Exchanges and qualified health plan (QHP) issuers, and the operation of state risk adjustment and reinsurance programs. In addition, this final rule clarifies standards for special enrollment periods, survey vendors that conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in the federally facilitated Exchange (FFE). This document provides a high-level summary of these rules and highlights key changes to the regulation since the issuance of the proposed rule.

Click here to view the publication.