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- 45 CFR 155.1000 · Certification standards for QHPs.
- 45 CFR 155.1010 · Certification process for QHPs.
- 45 CFR 155.1020 · QHP issuer rate and benefit information.
- 45 CFR 155.1030 · QHP certification standards related to advance payments of the premium tax credit and cost-sharing reductions.
- 45 CFR 155.1040 · Transparency in coverage.
- 45 CFR 155.1045 · Accreditation timeline.
- 45 CFR 155.1050 · Establishment of Exchange provider access standards.
- 45 CFR 155.1051 · Effective Essential Community Provider Review Program.
- 45 CFR 155.1055 · Service area of a QHP.
- 45 CFR 155.1065 · Stand-alone dental plans.
- 45 CFR 155.1075 · Recertification of QHPs.
- 45 CFR 155.1080 · Decertification of QHPs.
- 45 CFR 155.1090 · Request for the reconsideration of a denial of certification.
- 45 CFR 155.1200 · General program integrity and oversight requirements.
- 45 CFR 155.1210 · Maintenance of records.
- 45 CFR 155.1300 · Basis and purpose.
- 45 CFR 155.1302 · Coordinated waiver process.
- 45 CFR 155.1304 · Definitions.
- 45 CFR 155.1308 · Application procedures.
- 45 CFR 155.1312 · State public notice requirements.
- 45 CFR 155.1316 · Federal public notice and approval process.
- 45 CFR 155.1318 · Modification from the normal public notice requirements during an emergent situation.
- 45 CFR 155.1320 · Monitoring and compliance.
- 45 CFR 155.1322 · Pass-through funding for approved waivers.
- 45 CFR 155.1324 · State reporting requirements.
- 45 CFR 155.1328 · Periodic evaluation requirements.
- 45 CFR 155.1330 · Waiver amendment.
- 45 CFR 155.1332 · Waiver extension.
- 45 CFR 155.1400 · Quality rating system.
- 45 CFR 155.1405 · Enrollee satisfaction survey system.
- 45 CFR 155.1500 · Purpose and scope.
- 45 CFR 155.1505 · Definitions.
- 45 CFR 155.1510 · Data submission.
- 45 CFR 155.1515 · Pre-testing and assessment procedures.
- 45 CFR 155.1600 · Purpose and scope.
- 45 CFR 155.1605 · Applicability date and implementation.
- 45 CFR 155.1610 · Definitions.
- 45 CFR 155.1615 · Information submission.
- 45 CFR 155.1620 · Sampling procedures.
- 45 CFR 155.1625 · Determining payment errors.
- 45 CFR 155.1630 · Difference Resolution and appeal process.
- 45 CFR 155.1635 · Corrective action plan (CAP).
- 45 CFR 155.1640 · SEIPM preparation phase.
- 45 CFR 155.1645 · Minimizing potential duplicate audit requirements.
- 45 CFR 155.1650 · Failure to comply.
- 45 CFR 156.10 · Basis and scope.
- 45 CFR 156.20 · Definitions.
- 45 CFR 156.50 · Financial support.
- 45 CFR 156.80 · Single risk pool.
- 45 CFR 156.100 · State selection of benchmark plan for plan years beginning prior to January 1, 2020.
- 45 CFR 156.105 · Determination of EHB for multi-state plans.
- 45 CFR 156.110 · EHB-benchmark plan standards.
- 45 CFR 156.111 · State selection of EHB-benchmark plan for plan years beginning on or after January 1, 2020.
- 45 CFR 156.115 · Provision of EHB.
- 45 CFR 156.120 · Collection of data to define essential health benefits.
- 45 CFR 156.122 · Prescription drug benefits.
- 45 CFR 156.125 · Prohibition on discrimination.
- 45 CFR 156.130 · Cost-sharing requirements.
- 45 CFR 156.135 · AV calculation for determining level of coverage.
- 45 CFR 156.136 · Expanded cost-sharing parameters.
- 45 CFR 156.140 · Levels of coverage.
- 45 CFR 156.145 · Determination of minimum value.
- 45 CFR 156.150 · Application to stand-alone dental plans inside the Exchange.
- 45 CFR 156.155 · Enrollment in catastrophic plans.
- 45 CFR 156.200 · QHP issuer participation standards.
- 45 CFR 156.210 · QHP rate and benefit information.
- 45 CFR 156.215 · Advance payments of the premium tax credit and cost-sharing reduction standards.
- 45 CFR 156.220 · Transparency in coverage.
- 45 CFR 156.221 · Access to and exchange of health data and plan information.
- 45 CFR 156.222 · Access to and exchange of health data for providers and payers.
- 45 CFR 156.223 · Prior authorization requirements.
- 45 CFR 156.225 · Marketing and benefit design of QHPs.
- 45 CFR 156.230 · Provider access standards for network plans.
- 45 CFR 156.235 · Essential community provider standards for network plans.
- 45 CFR 156.236 · Provider access and essential community providers standards for non-network plans.
- 45 CFR 156.245 · Treatment of direct primary care medical homes.
- 45 CFR 156.250 · Meaningful access to qualified health plan information.
- 45 CFR 156.255 · Rating variations.
- 45 CFR 156.260 · Enrollment periods for qualified individuals.
- 45 CFR 156.265 · Enrollment process for qualified individuals.
- 45 CFR 156.270 · Termination of coverage or enrollment for qualified individuals.
- 45 CFR 156.272 · Issuer participation for the full plan year.
- 45 CFR 156.275 · Accreditation of QHP issuers.
- 45 CFR 156.280 · Segregation of funds for abortion services.
- 45 CFR 156.285 · Additional standards specific to SHOP for plan years beginning prior to January 1, 2018.
- 45 CFR 156.286 · Additional standards specific to SHOP for plan years beginning on or after January 1, 2018.
- 45 CFR 156.290 · Non-certification and decertification of QHPs.
- 45 CFR 156.295 · Prescription drug distribution and cost reporting by QHP issuers.
- 45 CFR 156.330 · Changes of ownership of issuers of Qualified Health Plans in Federally-facilitated Exchanges.
- 45 CFR 156.340 · Standards for downstream and delegated entities.
- 45 CFR 156.350 · Eligibility and enrollment standards for Qualified Health Plan issuers on State-based Exchanges on the Federal platform.
- 45 CFR 156.400 · Definitions.
- 45 CFR 156.410 · Cost-sharing reductions for enrollees.
- 45 CFR 156.420 · Plan variations.
- 45 CFR 156.425 · Changes in eligibility for cost-sharing reductions.
- 45 CFR 156.430 · Payment for cost-sharing reductions.
- 45 CFR 156.440 · Plans eligible for advance payments of the premium tax credit and cost-sharing reductions.
- 45 CFR 156.460 · Reduction of enrollee's share of premium to account for advance payments of the premium tax credit.
- 45 CFR 156.470 · Allocation of rates for advance payments of the premium tax credit.
- 45 CFR 156.480 · Oversight of the administration of the advance payments of the premium tax credit, cost-sharing reductions, and user fee programs.