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GAO-14-462R 1 (2014-03-27)

handle is hein.gao/gaobadqeu0001 and id is 1 raw text is: G A O U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-325655 March 27, 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, Centers for Medicare & Medicaid Services: Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment in Standard Health Plans; Essential Health Benefits in Standard Health Plans; Performance Standards for Basic Health Programs; Premium and Cost Sharing for Basic Health Programs; Federal Funding Process; Trust Fund and Financial Integrity 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, Centers for Medicare & Medicaid Services (CMS) entitled Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment in Standard Health Plans; Essential Health Benefits in Standard Health Plans; Performance Standards for Basic Health Programs; Premium and Cost Sharing for Basic Health Programs; Federal Funding Process; Trust Fund and Financial Integrity (RIN: 0938-AR93). We received the rule on March 11, 2014. It was published in the Federal Register as a final rule on March 12, 2014. 79 Fed. Reg. 14,112. The final rule establishes the Basic Health Program (BHP), as required by section 1331 of the Affordable Care Act. The BHP provides states the flexibility to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Affordable Insurance Exchange (Exchange). The BHP complements and coordinates with enrollment in a qualified health plan (QHP) through the Exchange, as well as with enrollment in Medicaid and the Children's Health Insurance Program. The final rule also sets forth a framework for BHP eligibility and enrollment, benefits, delivery of health care services, transfer of funds to participating states, and federal oversight. Additionally, this final rule amends another rule issued by the Secretary of the Department of Health and Human Services in order to clarify the applicability of that rule to the BHP. GAO-14-462R

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