Dec. 7, 2015: CMS Issues Notices Regarding Insurer Information Collection


The Centers for Medicare and Medicaid Services issued a notice in the Dec. 1 Federal Register announcing a 60-day opportunity to comment on intended information collection activities related to compliance with individual and group market reforms; the establishment of state exchanges and certification of qualified health plans; exchange standards for employers; and eligibility determinations regarding insurance affordability programs, exchange enrollment, Medicaid and CHIP.

This activity coincides with other notices published by CMS over the last few weeks relating to information that health plans will be required to provide as a result of the recently published 2017 Benefit and Payment Parameters rule proposal.

These notices include information collection requests regarding provider network information; third party premium payment information; Affordable Care Act internal claims and appeals and external review procedures for non-grandfathered group health plans and issuers; and individual market issuers and marketplace quality standards.

CMS will utilize the information collected to assist with ensuring insurer compliance with requirements related to healthcare reform requirements.