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HHS/CMS RIN: 0938-AT53 Publication ID: Fall 2018 
Title: Exchange Program Integrity (CMS-9922-P) 
Abstract:

This rule proposes improvements to Exchange program integrity, ensuring that eligible enrollees receive the correct advanced payments of the premium tax credit, and conducting effective and efficient oversight of State-Based Exchanges.

 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
EO 13771 Designation: Regulatory 
CFR Citation: 45 CFR 155    45 CFR 156   
Legal Authority: Pub. L. 111-148   
Legal Deadline:  None

Statement of Need:

This proposed rule would propose changes to strengthen program integrity related to oversight of State Exchanges, and the operation of Exchanges.

Summary of the Legal Basis:

This rule addresses multiple sections of the Patient Protection and Affordable Care Act (Pub. L. 111148) and the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111152), which amended and revised several provisions of the Patient Protection and Affordable Care Act.

Alternatives:

The proposed policies are important for program integrity reasons. We considered variations on the proposed policies.

Anticipated Costs and Benefits:

We do not anticipate the proposed rule to be a significant regulatory action, but do anticipate it would generate costs on stakeholders.  We believes these costs will be offset by improvements in program integrity.

Risks:

If this regulation is not published timely, important program integrity improvements will be delayed.
Timetable:
Action Date FR Cite
NPRM  10/00/2018 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Federal, State 
Federalism: Yes 
Included in the Regulatory Plan: Yes 
RIN Data Printed in the FR: No 
Agency Contact:
Jeff Wu
Deputy Director for Policy
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Consumer Information and Insurance Oversight, MS: 733H.02, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:301 492-4305
Email: jeff.wu@cms.hhs.gov