Becker's Healthcare December 20, 2019
CMS issued a final rule Dec. 20 that aims to strengthen the integrity of state-based insurance exchanges under the ACA and includes separate billing for abortion services.
The final rule requires exchanges to conduct regular eligibility verifications with outside data sources, such as Medicare and Medicaid, at least twice annually, beginning with plan year 2021.
This eligibility verification requirement will help ensure exchanges are correctly determining consumer eligibility for advance payments of the premium tax credit and cost-sharing reduction amounts, CMS said in a news release.
“Early identification of eligibility and enrollment issues is particularly important for consumers who are eligible for or enrolled in other coverage because it can minimize the time these consumers inadvertently receive tax credits that...
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