ComplianceMnthlyRecap MH 5.16.22

CMS Publishes 2020 Benefit Payment and Parameters Final Rule

Posted by: Karen Hsu    Jun 13, 2019 12:05:12 PM

shutterstock_577768111-1The Centers for Medicare and Medicaid Services (CMS) published its final rule and fact sheet for benefit payment and parameters for 2020. Although the final rule primarily affects the individual market and the Exchanges, the final rule addresses the following topics that may impact employer-sponsored group health plans:

  • The 2020 maximum annual limitation on cost sharing is $8,150 for self-only coverage and $16,300 for other-than-self-only coverage.
  • For fully-insured plans, any indication of a reduction in the generosity of a benefit for individuals that is not based on clinically indicated, reasonable medical management practices is potentially discriminatory.
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Topics: health insurance, Medicaid, Centers for Medicare and Medicaid Services, Medicare coverage

CMS Releases 2020 Parameters for Medicare Part D Prescription Drug Benefit

Posted by: Karen Hsu    Jun 6, 2019 12:11:48 PM

The Centers for Medicare and Medicaid Services (CMS) released the following parameters for the defined standard Medicare Part D prescription drug benefit for 2020:

 

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Topics: Centers for Medicare and Medicaid Services, CMS, prescription drugs

Proposed 2020 Benefit Payment and Parameters Rule

Posted by: Karen Hsu    Jan 29, 2019 1:50:29 PM

shutterstock_95385217The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology.

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Topics: Centers for Medicare and Medicaid Services, Affordable Care Act, Benefit Payment and Parameters rule

What Employers Need to Know about the IRS-SSA-CMS Data Match Program

Posted by: Danielle Capilla    Jun 14, 2016 9:30:00 AM

Match puzzle piecesBeginning in early 2016, many employers received letters from the IRS-SSA-CMS Data Match program. These letters are addressed to the employer and begin by stating that "Medicare needs your cooperation." Employers are directed to report information on the IRS/SSA/CMS Data Match Secure Web Site (https://www.cob.cms.hhs.gov/DataMatch/). The data being requested is often extensive, and can cover a number of years.

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Topics: Centers for Medicare and Medicaid Services, Group health plans, Danielle Capilla, IRS-SSA-CMS Data Match Program

Transitional Reinsurance Fee Filing Date Extended to December 5

Posted by: Linda Rowings    Nov 20, 2014 2:08:00 PM

TRF Filing Date Extended to December 5The Centers for Medicare and Medicaid Services (CMS) extended the deadline for group health plans to provide their 2014 transitional reinsurance fee (TRF) submission. Filing is now due by 11:59 p.m. on December 5, 2014. The January 15, 2015, and November 15, 2015, deadlines to pay the fee remain the same. For more information on the TRF, see our recent blog. For the answers to nearly 30 questions about filing, due dates, calculation methods, payment, submission and more, CLICK HERE to Request UBA's "Frequently Asked Questions about the Transitional Reinsurance Fee (TRF)".

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Topics: Centers for Medicare and Medicaid Services, TRF, Transitional Reinsurance Fee, extended, December 5, CMS

Deadline Approaching for Larger Self-Funded Health Plans To Obtain a Health Plan Identifier Number

Posted by: Linda Rowings    Oct 21, 2014 10:08:00 AM

describe the imageTo meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health plans do not have receipts, insured plans should look at premiums for the prior plan year and self-funded plans should look at claims paid for the prior plan year. Small health plans (those with less than $5 million in claims during the prior plan year) have until November 5, 2015, to obtain an HPID.

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Topics: Self-Funded, HPID, Deadline, HHS, Centers for Medicare and Medicaid Services, Form 5500