AHIP Comments On Patient Protection And Affordable Care Act; Exchange Program Integrity

posted by AHIP

on January 7, 2019

AHIP submitted comments in response to the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) Exchange Program Integrity Proposed Rule, published in the Federal Register on November 9, 2018.

Because AHIP believes Americans deserve a stable, competitive individual market , we support rules that ensure exchanges are stable, operate efficiently and effectively, and encourage consumers to get covered. To advance these goals, we support:

  • Proposed changes to authorize access to additional data sources so Exchanges can verify a consumer’s eligibility for coverage, and
  • Expanding the scope and frequency of periodic data matching (PDM) for all Exchanges.

At the same time, we have serious concerns with any proposals that create a more complex and confusing consumer experience, impose new costs on consumers, and could increase premiums by imposing new costs on health insurance providers. These factors together could result in enrollees losing or going without the financial security coverage offers. As a result, we strongly oppose the proposed requirement that health insurance providers send separate bills and collect separate payments for the portion of the monthly premium attributable to coverage of non-Hyde services.