CCIIO Releases Guidance on Health Plan Reenrollment in the Federally Facilitated Marketplace

CCIIO recently released an Issuer Bulletin in follow up to final rules from September 2014 that detail the Federally Facilitated Marketplace’s and issuers’ roles in renewing coverage in 2015. The Bulletin describes the limited circumstances under which individuals are not eligible for automatic reenrollment - including those with discontinued coverage or without key application data, out-of-area enrollments, and existing enrollees from Oregon and Nevada who applied last year through their State-based Marketplaces - noting that these individuals may experience a gap in coverage if they do not select a plan by December 15. The Agency also announced it will create a daily "Enrollee Switched List" that enables FFM issuers to identify and “non-renew” existing enrollees who elected a different issuer for 2015 coverage, as the FFM will not send 834 termination files in these instances.

CMS Releases Final Rule on Disproportionate Share Hospital Payments

CMS released a final rule clarifying a change in the methodology for calculating Medicaid Disproportionate Share Hospital (DSH) Payments that, CMS notes, provides flexibility for states to calculate hospital-specific DSH limits. In a departure from previous guidance, this rule allows states and hospitals to calculate uncompensated costs based on the specific services provided to uninsured individuals rather than on the number of uninsured individuals serviced by the hospital.

HHS Finds Lowest-Cost SHOP Marketplaces’ Premium Rates Hold Steady

Average premiums in the Federally Facilitated Marketplace Small Business Health Options Program (SHOP) Marketplaces have remained steady or declined slightly for the lowest-cost bronze, silver and gold plans from 2014 to 2015, according to an HHS blog post. Where premiums increased, the uptick was relatively small; average premiums for the median-priced plan across SHOP Marketplaces increased by 2.1% for bronze, 0.7% for silver, and 1.6% for gold.