On October 30, 2013, CMS published a final rule that sets forth financial integrity and oversight standards for participants in Affordable Care Act (ACA) Insurance Exchanges/Marketplaces. According to a CMS press release, these policies largely are unchanged from previous proposed rules and guidance documents. Among other things, the rule addresses: oversight of state-operated risk adjustment and reinsurance programs; oversight of advanced payments of the premium tax credit and cost-sharing reductions; monitoring standards related to various Marketplace activities; approval of vendors to administer enrollee satisfaction surveys; and amendments to definitions and standards related to market reform rules. The rule also amends and finalizes certain interim provisions set forth in a March 11, 2013 interim final rule regarding risk corridors and cost-sharing reduction reconciliation.
