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GAO-14-461R 1 (2014-03-25)

handle is hein.gao/gaobadqet0001 and id is 1 raw text is: 



GAO U.S. GOVERNMENT ACCOUNTABILITY OFFICE
441 G St. N.W.
Washington, DC 20548


B-325654


March 25, 2014

The Honorable Ron Wyden
Chairman
The Honorable Orrin G. Hatch
Ranking Member
Committee on Finance
United States Senate

The Honorable Fred Upton
Chairman
The Honorable Henry A. Waxman
Ranking Member
Committee on Energy and Commerce
House of Representatives

Subject: Department of Health and Human Services, Patient Protection and Affordable Care
        Act; HHS Notice of Benefit and Payment Parameters for 2015

Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule
promulgated by the Department of Health and Human Services (HHS) entitled Patient
Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2015
(RIN: 0938-AR89). We received the rule on March 11, 2014. It was published in the Federal
Register as a final rule on March 11, 2014, with an effective date of May 12, 2014. 79 Fed.
Reg. 13,744.

The final rule sets forth payment parameters and oversight provisions related to the risk
adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing
reductions; and user fees for federally-facilitated exchanges. It also provides additional
standards with respect to composite premiums, privacy and security of personally identifiable
information, the annual open enrollment period for 2015, the actuarial value calculator, the
annual limitation in cost sharing for stand-alone dental plans, the meaningful difference standard
for qualified health plans offered through a federally-facilitated exchange, patient safety
standards for issuers of qualified health plans, and the Small Business Health Options Program.

Enclosed is our assessment of HHS's compliance with the procedural steps required by section
801 (a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review of the procedural steps
taken indicates that HHS complied with the applicable requirements.

If you have any questions about this report or wish to contact GAO officials responsible for the
evaluation work relating to the subject matter of the rule, please contact Shirley A. Jones,
Assistant General Counsel, at (202) 512-8156.


GAO-i 4-461 R

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