CMS’ Draft Letter To Issuers Hints At Audits, Largely Mirrors Prior Policies

By Amy Lotven / January 23, 2019 at 7:00 PM

CMS’ annual letter describing key policy changes for health and dental plan issuers seeking to participate in the federally facilitated marketplaces in the 2020 plan year largely relies on processes spelled out in previous letters, but it does warn the agency may audit issuers to ensure they’re following rules on cost-sharing for out-of-network services provided in an in-network setting.


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