CMS Final Rule Does Not Answer Insurers' Biggest Questions

By Jeremy Earl, Ankur Goel and Seth Schneer, McDermott Will & Emery LLP (April 28, 2017, 1:33 PM EDT) -- The Centers for Medicare and Medicaid Services recently released a final rule with the goal of stabilizing exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and exchange qualified health plan application submissions, adopted a good faith compliance standard for 2018 and delegated additional plan certification responsibilities to states. While these steps may provide some comfort for issuers, the agency did not address the most significant areas of issuer concern when it comes to 2018 exchange participation. Namely, the final rule and guidance documents do not resolve ongoing uncertainty regarding cost-sharing reduction funding, the enforcement of the individual mandate or ongoing efforts to repeal the Affordable Care Act....

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