CMS has published a final rule that implements various Medicaid and Children's Health Insurance Program (CHIP) eligibility, appeals, and related administrative changes under the Affordable Care Act (ACA) that were proposed in January 22, 2013 but not included in a July 15, 2013 rule finalizing selected provisions. According to CMS, the rule will support "modernization of notices and appeals processes and the coordination of eligibility notices and appeals across insurance affordability programs" and simplify eligibility and enrollment policies. The rule is effective January 20, 2017. CMS also issued a companion proposed rule to further revise Medicaid eligibility and appeals provisions in response to feedback on the January 22, 2013 proposed rule and its experience working with states and exchanges on eligibility determinations and appeals. Comments on the proposed rule will be accepted until January 23, 2017. Ultimately, implementation of these ACA-related regulations will be tied to the broader fate of the ACA under the Trump Administration and Republican Congress.
This article is presented for informational purposes only and is not intended to constitute legal advice.