HCR - Health & Human Services

Annual Limit Waivers

Regulations :

June 28, 2010
OCIIO–9994–IFC: Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections

Guidance:

• September 3, 2010
  OCIIO Sub-Regulatory Guidance: Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711 (PDF – 48 KB)
• November 5, 2010
  OCIIO Supplemental Guidance: Waivers of the Annual Limits Requirements (PDF – 61 KB)
• December 9, 2010
  OCIIO Supplemental Guidance: Consumer Notices on Waivers of the Annual Limits Requirements (PDF – 53 KB)
• December 9, 2010
  OCIIO Supplemental Guidance: Sale of New Business by Issuers Receiving Waivers (PDF – 55 KB)

Coverage for Young Adults

Regulations:

• May 13, 2010
  OCIIO – 4150 – IFC: Group Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient Protection and Affordable Care Act (PDF – 178 KB)

Guidance:

• October 13, 2010
  Q&A: Enrollment of Children Under 19 Under the New Policy That Prohibits Pre-Existing Condition Exclusions

Grandfathered Plans

Regulations:

• June 17, 2010
  OCIIO–9991–IFC: Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act (PDF – 258)
  
• November 15, 2010
  OCIIO–9991–IFC2:  Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act

Guidance:

Medical Loss Ratio

Regulations:

• December 1, 2010
  OCIIO–9998–IFC: Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act (PDF – 2 MB) 

Guidance:

• December 17, 2010
  OCIIO Technical Guidance: Process for a State to Submit a Request for Adjustment to the Medical Loss Ratio Standard of PHS Act Section 2718 (PDF – 35 KB)
• April 26, 2011
  CCIIO Technical Guidance: Submission of 2011 Quarterly Reports of MLR Data by Issuers of “Mini-med” and Expatriate Plans (PDF – 26 KB)

Patient’s Bill of Rights

Regulations:

• June 28, 2010
  OCIIO–9994–IFC: Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections

Guidance:

• September 3, 2010
  OCIIO Sub-Regulatory Guidance: Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711

Prevention

Regulations:

• July 19, 2010
  OCIIO–9992–IFC: Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services under the Patient Protection and Affordable Care Act

Guidance:

• July 19, 2010
  Recommendation: Recommendations of the U.S. Preventive Service Task Force

Review of Insurance Rates

Regulations:

December 23, 2010
OCIIO–9998–IFC: Rate Increase Disclosure and Review; Proposed Rule (PDF – 215 KB)

Guidance:

Health Insurance Exchanges

Planning and Establishment Grants
November 18, 2010
Guidance: Initial Guidance to States on Exchanges

Information Technology Systems
November 3, 2010
Guidance: Exchange and Medicaid Information Technology (IT) Systems (PDF -110 KB)

State Innovations

Regulations:

• March 10, 2011
  Application, Review, and Reporting Process for Waivers for State Innovation (PDF – 125 KB)