0938-AT66 201810 The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions 0938 Centers for Medicare & Medicaid Services CMS 0900 Department of Health and Human Services HHS Patient Protection and Affordable Care Act; Adoption of the Methodology for the HHS-Operated Permanent Risk Adjustment Program for the 2018 Benefit Year Proposed Rule (CMS-9919-F)

This final rule sets forth the rationale for selecting the statewide average premium as the cost-scaling parameter in the risk adjustment methodology that HHS uses when operating the permanent risk adjustment program established in section 1343 of the Patient Protection and Affordable Care Act on behalf of a state for the 2018 benefit year. The HHS-operated risk adjustment methodology includes the payment transfer formula which utilizes the statewide average premium to achieve budget neutrality. This aspect of the HHS-operated risk adjustment methodology was vacated by the decision of the United States District Court for the District of New Mexico as to its use for the 2014 through 2018 benefit years.

]]> Economically Significant First Time Published in The Unified Agenda Final Rule Stage Yes No Other 45 CFR 153 Pub. L. 111-148, sec. 1343 No NPRM 08/10/2018 83 FR 39644 NPRM Comment Period End 09/07/2018 Final Action 01/00/2019 No Federal State No No No 0938-AT65 Related to Lindsey Murtagh Director, Division of Regulations and Policy 0938 Centers for Medicare & Medicaid Services CMS 301 492-4106 lindsey.murtagh@cms.hhs.gov Center for Consumer Information and Insurance Oversight, 7500 Security Boulevard, Baltimore MD 21244