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B-334285 May 12, 2022 1 (2022-05-12)

handle is hein.gao/gaoncj0001 and id is 1 raw text is: .GAOU.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-334285 May 12, 2022 The Honorable Patty Murray Chairwoman The Honorable Richard Burr Ranking Member Committee on Health, Education, Labor, and Pensions United States Senate The Honorable Frank Pallone, Jr. Chairman The Honorable Cathy McMorris Rodgers Republican Leader 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 2023 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 2023 (RIN: 0938-AU65). We received the rule on May 5, 2022. It was published in the Federal Register as a final rule on May 6, 2022. 87 Fed. Reg. 27208. The effective date is July 1, 2022. The final rule, according to HHS, includes payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs, as well as 2023 user fee rates for issuers offering qualified health plans (QHPs) through federally-funded Exchanges and state-based Exchanges on the federal platform. Also, HHS stated that the rule includes requirements related to guaranteed availability; the offering of QHP standardized plan options through Exchanges on the federal platform; requirements for agents, brokers, and web-brokers; verification standards related to employer sponsored coverage; Exchange eligibility determinations during a benefit year; special enrollment period verification; cost-sharing requirements; Essential Health Benefits; Actuarial Value; QHP issuer quality improvement strategies; accounting for quality improvement activity expenses and provider incentives for medical loss ratio reporting and rebate calculation purposes; and re-enrollment. Lastly, HHS stated that the rule responds to comments on how HHS can advance health equity through QHP certification standards and otherwise in the individual and group health insurance markets, and how HHS might address plan choice overload in the Exchanges. The Congressional Review Act (CRA) requires a 60-day delay in the effective date of a major rule from the date of publication in the Federal Register or receipt of the rule by Congress, whichever is later. 5 U.S.C. § 801(a)(3)(A). This final rule was published on May 6, 2022. 87 Fed. Reg. 27208. The Congressional Record does not yet reflect receipt of the rule by either

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