News & Analysis as of

Federally Facilitated Exchanges Qualified Health Plans

McDermott Will & Emery

CMS Interoperability and Prior Authorization Rule Significantly Impacts Payers’ Approval and Denial Practices

McDermott Will & Emery on

On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization final rule (Final Rule) (fact sheet, CMS’ interoperability website), which aims to improve prior...more

Groom Law Group, Chartered

CMS Proposed Rule Would Leverage Technology and Interoperability to Improve Prior Authorization

On Tuesday, December 13, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“New Proposed Rule”) to improve the prior authorization process and advance interoperability for Medicare Advantage...more

King & Spalding

HHS Releases Notice of Benefit and Payment Parameters 2023 Proposed Rule

King & Spalding on

On December 28, 2021, HHS released a proposed rule governing plans issued in the Patient Protection and Affordable Care Act (ACA) marketplaces beginning with the 2023 plan year (the Proposed Rule). Among other changes to the...more

Epstein Becker & Green

CMS's Final Exchange and Insurance Market Standards Impact Qualified Health Plan Filings for 2015 and Beyond

On May 16, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule titled "Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond" ("Final Rule")...more

Morgan Lewis

CMS Proposes Rule for Exchanges and SHOPs Under the Affordable Care Act

Morgan Lewis on

New marketing integrity and oversight provisions warrant review and comment. On June 14, the Centers for Medicare and Medicaid Services (CMS) in the U.S. Department of Health and Human Services (HHS) published its...more

Baker Donelson

Affordable Care Act: Navigators Get Clarified and Standardized in CMS's Latest Proposed Rule

Baker Donelson on

On Friday, April 5, 2013, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (45 CFR Part 155) that clarifies and implements standards for providers of consumer-related assistance under the...more

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