Fact Based List:
CMS: Benefit and Payment Parameters Final Rule, 6 Updates
Submitted by Anonymous on Thu, 12/22/2016 - 12:33
- CMS will establish a high-cost risk pool calculation in its risk adjustment methodology.
- CMS will code several special enrollment periods to curb misuse and ensure regulation clarity.
- CMS will address feedback that the current risk adjustment model underpredicts claims costs for individuals enrolled in health plans for only a portion of the year.
- Prescription drug use data will be incorporated in risk adjustment models to better account for health risks of individuals with serious health issues.
- CMS decided to maintain the user fee for federally-facilitated marketplaces at 3.5 percent of premiums for the 2018 benefit year.
- A maximum annual limitation on cost sharing for 2018 of $7,350 for individuals and $14,700 for families was finalized.
Source: Becker's Hospital Review
Source URL: http://www.beckershospitalreview.com/payer-issues/12-things-...
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