Epstein Becker Green Client Alert “CMS Final Exchange and Insurance Market Standards” Featured in Express Script’s Healthcare Reform Quarterly Update Newsletter

Express Script’s Healthcare Reform Quarterly Update

Express Script’s Healthcare Reform Quarterly Update Newsletter recently featured an Epstein Becker Green client alert, "CMS’s Final Exchange and Insurance Market Standards Impact Qualified Health Plan Filings for 2015 and Beyond," by Helaine I. Fingold, Mark Hamelburg, Philo D. Hall, S. Lawrence Kocot, and Thomas E. Hutchinson.

Following is an excerpt:

On May 27, 2014, the CMS published the final rule, Exchange and Insurance Market Standards for 2015 and Beyond. The rule included the two pharmacy impact items summarized in more detail above (24 hour Exigent Circumstances and QRS). Other items contained in the regulation impacting clients include:

  • Termination of Coverage,
  • Standardizing Consumer Notices: Discontinuing or Renewing a Product in Individual or Group Market
  • Calculating Payment of Premiums
  • Providing more Small Business Health Options Program (SHOP) Options
  • Redefining Standards for Reinsurance, Risk Corridors and Risk Adjustments
  • Outlining Issuer Use of Premium Revenue: Reporting and Rebate Requirements

To read more about the Exchange and Insurance Market Standards for 2015 and Beyond, see the Health Affairs Blog and/or the Epstein Becker Green client alert.