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Life Health > Health Insurance

CMS gives 2016 exchange plan reporting details

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The Centers for Medicare & Medicaid Services (CMS) has posted the paperwork review application for a new exchange plan public reporting program.

CMS, an arm of the U.S. Department of Health and Human Services (HHS), wants to start using the program to beef up the information that the system displays for the 2016 plan year.

Section 1311(e)(3) of the Patient Protection and Affordable Care Act of 2010 (PPACA) requires that the public exchange system provide detailed information about health plans and health insurers.

Open enrollment for the 2016 plan year is set to start Nov. 1, 2015 and last until Jan. 31, 2016.

CMS says, in a statement explaining the “transparency” reporting program, that it will phase in the new requirements to give health insurers time to update information technology systems and begin collecting the required data.

Eventually, similar transparency reporting requirements will apply to state-run exchanges, and a separate set of transparency requirements will apply to off-exchange medical insurance and self-insured group health plans, CMS says.

CMS says it will start collecting the required data via e-mail, but hopes to align the data collection process with the federal Health Insurance Oversight System (HIOS) and the System for Electronic Rate and Form Filing (SERFF), a system developed by the National Association of Insurance Commissioners (NAIC).

CMS is asking for feedback on the information it should post on, but it suggests that it might post issuer-level enrollment data, issuer financial data from the previous year, and a link to a website an issuer will use to explain how it handles out-of-network claims and balance billing.

See also: Feds designing PPACA plan hole analyzer

In an impact analysis, CMS says 475 issuers are selling qualified health plan (QHP) coverage stand-alone dental plans through exchanges this year.

See also: CMS: We have 46 percent more PPACA exchange agents


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