GroundRules
45 CFR 154.210: Review of rate increases subject to review by CMS or by a State.
Where this section sits in the code
- Title 45—Public Welfare
- SUBTITLE A—Department of Health and Human Services
- SUBCHAPTER B—REQUIREMENTS RELATING TO HEALTH CARE ACCESS
- PART 154—HEALTH INSURANCE ISSUER RATE INCREASES: DISCLOSURE AND REVIEW REQUIREMENTS
- Subpart B—Disclosure and Review Provisions
(a) Except as provided in paragraph (b) of this section, CMS will review a rate increase subject to review to determine whether it is unreasonable, as required by this part.
(b) CMS will adopt a State's determination of whether a rate increase is an unreasonable rate increase, if the State:
(1) Has an Effective Rate Review Program as described in § 154.301; and
(2) The State provides to CMS, on a form and in a manner prescribed by the Secretary, its final determination of whether a rate increase is unreasonable, which must include a brief explanation of how its analysis of the relevant factors set forth in § 154.301(a)(3) caused it to arrive at that determination, within five business days following the State's final determination.
(c) CMS will post and maintain on its Web site a list of the States with market segments that meet the requirements of paragraph (b) of this section.
Collected 2026-08-27T02:26:21Z. Source file · JSON