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HHS/CMS RIN: 0938-AT97 Publication ID: Fall 2021 
Title: Policy and Technical Changes to the Medicare Advantage Program and Medicare Prescription Drug Benefit Program; MOOP and Cost Sharing Limits (CMS-4190) 
Abstract:

This third final rule will finalize the two remaining proposals from the February 2020 proposed rule regarding the maximum out-of-pocket (MOOP) limits for Medicare Parts A and B services and service category cost sharing limits for Medicare Parts A and B services and per member per month actuarial equivalence cost sharing.  

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Long-Term Actions 
Major: Yes  Unfunded Mandates: No 
CFR Citation: 42 CFR 405    42 CFR 417    42 CFR 422    42 CFR 423    ...     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: 42 U.S.C. 1302    42 U.S.C. 1320b-12    42 U.S.C. 1395x    42 U.S.C. 1395y(a)    42 U.S.C. 1395ff    42 U.S.C. 1395hh    42 U.S.C. 1395kk    42 U.S.C. 1395rr    42 U.S.C. 1395ww(k)   
Legal Deadline:
Action Source Description Date
Final  Statutory  MMA sec. 902 requires Medicare final rules publish within 3 years of a proposed or interim final rule.  02/18/2023 

Overall Description of Deadline: Per the CMS notice published December 30, 2004 (69 FR 78442), except for certain Medicare payment regulations and certain other statutorily-mandated regulations, we schedule all Medicare final regulations for publication within the 3-year standardized time limit in the current Unified Agenda. We do not intend to delay publishing a Medicare final regulation for 3 years if we are able to publish it sooner.

Timetable:
Action Date FR Cite
NPRM  02/18/2020  85 FR 9002   
NPRM Comment Period End  04/06/2020 
Final Action  06/02/2020  85 FR 33796   
Final Action Effective  08/03/2020 
2nd Final Action  01/19/2021  86 FR 5864   
2nd Final Action Effective  03/22/2021 
3rd Final Action  02/00/2023 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Heather Rudo
Director, Division of Policy, Analysis, and Planning
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare, MS: C4-21-26, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-7627
Email: heather.rudo@cms.hhs.gov