Wednesday, May 25, 2016

CMS Rule Tightens Special Enrollment Periods

Dianne De La Mare


The US Department of Health, Centers for Medicare & Medicaid Services (CMS) has released an interim final rule, Patient Protection and Affordable Care Act; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program.  This requires individuals who enroll in Healthcare.gov coverage through a special enrollment period after a permanent move to prove that they were previously covered for at least 1 day in the 60 days before relocating. 

CMS states that making those changes faster through an interim final rule is necessary to avoid adverse selection or gaming, and it also helps to ensure that issuers have confidence in their pricing.

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