The Congressional Research Service published a report detailing more than a dozen pending ACA-related rulemakings. The report comes on the heels of the Spring 2014 Unified Agenda and identifies 14 proposed rules and 17 final rules regarding the ACA that are expected during the next twelve months. Notable expected proposed rules include:
- CY 2016 Notice of Benefit and Payment Parameters (CMS-9933-P) (0938-ASI9)—Expected in November 2014, this rule would provide the CY 2016 payment parameters for Exchanges, including cost-sharing reductions, advance premium tax credits, reinsurance, and risk adjustment.
- Application of the Mental Health Parity and Addiction Equity Act to Medicaid Programs (CMS-2333-P) (0938-AS24)—Expected in December 2014, this rule would specify how MHPAEA would apply to Medicaid (including managed care), CHIP, and other benefit programs.
- Nondiscrimination Under the Patient Protection and Affordable Care Act (0945-AA02)—Expected in August 2014, this rule would implement the ACA Section 1557’s prohibitions against discrimination in health programs and activities by covered entities on the basis of race, color, national origin, sex, age, and disability.
- State Option to Provide Health Homes for Enrollees With Chronic Conditions (CMS-2331-P) (0938-AQ48)—Expected in October 2014, this proposed rule would provide guidance for development of a Medicaid State Plan option to provide health homes for enrollees with chronic conditions.
Notable expected final rules include:
- Reporting and Returning of Overpayments (CMS-6037-F) (0938-AQ58)—Expected in February 2015, this rule would finalize implementation of the process by which providers and suppliers return overpayments under Medicare and the process by which CMS and its contractors receive and apply it.
- Adoption of Operating Rules for HIPAA Transactions (CMS-0036-IFC) (0938-AS01)—Expected as an interim final rule in March 2015, this rule would establish operating requirements for HIPAA transactions for claims and encounter information, enrollment and disenrollment of a health plan, premium payments, and referral certifications and authorizations.