Code of Federal Regulations (Last Updated: October 10, 2024) |
Title 45 - Public Welfare |
Subtitle A - Department of Health and Human Services |
SubChapter B - Requirements Relating to Health Care Access |
Part 156 - Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges |
Subpart L - Quality Standards |
§ 156.1120 - Quality rating system.
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§ 156.1120 Quality rating system.
(a) Data submission requirement.
(1) A QHP issuer must submit data to HHS and Exchanges to support the calculation of quality ratings for each QHP that has been offered in an Exchange for at least one year.
(2) In order to ensure the integrity of the data required to calculate the QRS, a QHP issuer must submit data that has been validated in a form and manner specified by HHS.
(3) A QHP issuer must include in its data submission information only for those QHP enrollees at the level specified by HHS.
(b) Timeline. A QHP issuer must annually submit data necessary to calculate the QHP's quality ratings to HHS and Exchanges, on a timeline and in a standardized form and manner specified by HHS.
(c) Marketing requirement. A QHP issuer may reference the quality ratings for its QHPs in its marketing materials, in a manner specified by HHS.
(d) Multi-State plans. Issuers of multi-State plans, as defined in § 155.1000(a) of this subchapter, must provide the data described in paragraph (a) of this section to the U.S. Office of Personnel Management, in the time and manner specified by the U.S. Office of Personnel Management.
[79 FR 30352, May 27, 2014]