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GAO-14-656R 1 (2014-06-11)

handle is hein.gao/gaobadqix0001 and id is 1 raw text is: c AO U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-325884 June 11, 2014 The Honorable Tom Harkin Chairman The Honorable Lamar Alexander Ranking Member Committee on Health, Education, Labor, and Pensions 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; Exchange and Insurance Market Standards for 2015 and Beyond 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; Exchange and Insurance Market Standards for 2015 and Beyond (RIN: 0938-AS02). We received the rule on May 20, 2014. It was published in the Federal Register as a final rule on May 27, 2014. 79 Fed. Reg. 30,240. The final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (Exchanges), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in federally-facilitated Exchanges. It also finalizes: a modification of HHS's allocation of reinsurance collections if those collections do not meet HHS's projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way HHS calculates the annual limit on cost sharing; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards GAO-14-656R

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