CMS Issues Proposed Pre-Eligibility Verification Process Rule For Marketplace Products

The Centers for Medicare & Medicaid Services released a proposed rule that establishes a Marketplace pre-eligibility verification process. As prescribed by the Working Families Tax Cuts act (H.R. 1), the proposed rule would require marketplace plans to verify household income, family size, status of a citizen, eligibility for or enrollment in other qualifying coverage and place of residence prior to receiving advanced premium tax credit or cost-sharing reductions. Consumers can still enroll without financial assistance while verifications are pending. Comments are due 30 days following publication within the Federal Register. The Missouri Hospital Association published an issue brief with additional details.