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B-331008 1 (2019-05-09)

handle is hein.gao/gaobadzgm0001 and id is 1 raw text is: GAO U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-331008 May 9, 2019 The Honorable Lamar Alexander Chairman The Honorable Patty Murray Ranking Member Committee on Health, Education, Labor, and Pensions United States Senate The Honorable Frank Pallone, Jr. Chairman The Honorable Greg Walden Ranking Member Committee on Energy and Commerce House of Representatives The Honorable Richard Neal Chairman The Honorable Kevin Brady Ranking Member Committee on Ways and Means House of Representatives Subject: Department of Health and Human Services: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020 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 and Medicaid Services (CMS) entitled Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020 (RIN: 0938-AT37). We received the rule on April 25, 2019. It was published in the Federal Register as a final rule on April 25, 2019. 84 Fed. Reg. 17454. The effective date of the rule is June 24, 2019. This final rule sets forth payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs, cost-sharing parameters, and user fees for federally- facilitated exchanges and state-based exchanges on the federal platform. According to HHS, this final rule will allow greater flexibility related to the duties and training requirements for the Navigator program' and changes that will provide greater flexibility for direct enrollment entities, while strengthening program integrity oversight over those entities. HHS also stated that this final rule is intended to reduce the costs of prescription drugs. Lastly, this final rule changes exchange standards related to eligibility and enrollment; exemptions; and other related topics. 1 Exchanges are required to establish Navigator programs under which they award grants to entities to conduct public education activities to raise awareness of the availability of qualified health plans, among other things.

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