Implementation of the Affordable Care Act

7/30/2019 Implementation of the Affordable Care Act

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November 19, 20121

TOPIC OF REGULATION ACA SECTION(S)

IMPLEMENTED (PHS ACT

SECTION AMENDED) OR

OTHER RELATED STATUTE

REGULATION TYPE OR

ACTION

FED. REG.

PUBLICATION DATE,

VOLUME, PAGE

COMMENT DUE

DATE

EFFECTIVE DATE OF

REGULATION

AGENCY

Preexisting Conditions Exclusions

Lifetime & Annual Limits

Rescission

Patient Protections

1001 ACA (PHS Act 2704)

1001 ACA (PHS Act 2711)

1001 ACA (PHS Act 2712)

1001 ACA (PHS Act 2719A)

Interim Final Rule &

Request for Comments

June 28, 2010

75 Fed. Reg. 123, 37188

Aug. 27, 2010 Aug. 27, 2010 IRS

EBSA

HHS

Preventive Services 1001 ACA (PHS Act 2713) Interim Final Rule &


July 19, 2010

75 Fed. Reg. 137, 41726

Sept. 17, 2010 Sept. 17, 2010 IRS

EBSA

HHS

Dependent Coverage of Children to

Age 26

1001 ACA (PHS Act 2714) Interim Final Rule &


May 13, 2010

75 Fed. Reg. 92, 27122

Aug. 11, 2010 July 12, 2010 IRS

EBSA

HHS

Medical Loss Ratio 1001 ACA (PHS Act 2718) Final Rule May 16, 2012

77 Fed. Reg. 28790

June 15, 2012 HHS

Internal Claims & Appeals &

External Review

1001 ACA (PHS Act 2719) Interim Final Rules &

Request for Comment

July 23, 2010

75 Fed. Reg. 141, 43330

Sept. 23, 2010 Sept. 23, 2010 IRS

EBSA

HHS
http://www.gpo.gov/fdsys/pkg/FR-2010-06-28/pdf/2010-15278.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-06-28/pdf/2010-15278.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-07-19/pdf/2010-17242.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-07-19/pdf/2010-17242.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-07-19/pdf/2010-17242.pdfhttp://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480aeca2b&disposition=attachment&contentType=pdfhttp://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480aeca2b&disposition=attachment&contentType=pdfhttps://www.federalregister.gov/articles/2012/05/16/2012-11753/medical-loss-ratio-requirements-under-the-patient-protection-and-affordable-care-acthttp://edocket.access.gpo.gov/2010/pdf/2010-18043.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-18043.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-18043.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-18043.pdfhttps://www.federalregister.gov/articles/2012/05/16/2012-11753/medical-loss-ratio-requirements-under-the-patient-protection-and-affordable-care-acthttp://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480aeca2b&disposition=attachment&contentType=pdfhttp://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480aeca2b&disposition=attachment&contentType=pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-07-19/pdf/2010-17242.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-07-19/pdf/2010-17242.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-06-28/pdf/2010-15278.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-06-28/pdf/2010-15278.pdf


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November 19, 20122

Group Health Plans and Health

Insurance Issuers: Internal Claims

and Appeals and External Review

Processes

1001 ACA (PHS Act 2719) Amendment To

Interim Final Rules

With Request For

CommentsJune 24, 2011

76 Fed. Reg. 122,

37208

July 25, 2011 July 22, 2011 HHS

IRS

Pre-Existing Condition Insurance

Plan Program

1101 ACA Final Rule Aug. 30, 2012

77 Fed. Reg. 52614

Aug. 30, 2012 HHS

Early Retiree Reinsurance Program 1102 ACA Notice Mar. 21, 2012

77 Fed. Reg. 16551

A sponsor will use

funds not later than

December 31, 2014

CMS

Health Care Reform Insurance Web

Portal Requirements

1103 ACA Interim Final Rule with

Comment Period

May 5, 2010

75 Fed. Reg. 86, 24470

June 4, 2010 May 10, 2010 HHS

Grandfathered Plans - Group Health

Plans and Health InsuranceCoverage Rules Relating to Status

as a Grandfathered Health Plan

Under the Patient Protection and

Affordable Care Act

1251 ACA Notice of Proposed

Rulemaking

Nov. 17, 2010

75 Fed. Reg. 221, 70159

Dec. 17, 2010 IRS

Essential Health Benefits Bulletin 1302(b) ACA Bulletin Dec. 16, 2011 January 31,

2012

CCIIO

Patient Protection and Affordable

Care Act; Establishment of

Exchanges and Qualified Health

Plans; Exchange Standards for

Employers

1311 ACA Final Rule, Interim

Final Rule

March 27, 2012

77 Fed. Reg. 18310

May 11, 2012 May 29, 2012 HHS

Regulations Pertaining to the

Disclosure of Return Information To

Carry Out Eligibility Requirements

for Health Insurance Affordability

Programs

1311 ACA NPRM and Notice of

Public Hearing

April 30, 2012

77 Fed. Reg. 25378

July 30, 2012 IRS
http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3https://www.federalregister.gov/articles/2012/08/30/2012-21519/pre-existing-condition-insurance-plan-programhttps://www.federalregister.gov/articles/2012/08/30/2012-21519/pre-existing-condition-insurance-plan-programhttps://www.federalregister.gov/articles/2012/03/21/2012-6728/early-retiree-reinsurance-program#p-3https://www.federalregister.gov/articles/2012/03/21/2012-6728/early-retiree-reinsurance-program#p-3http://www.federalregister.gov/articles/2010/05/05/2010-10504/health-care-reform-insurance-web-portal-requirementshttp://www.federalregister.gov/articles/2010/05/05/2010-10504/health-care-reform-insurance-web-portal-requirementshttp://www.federalregister.gov/articles/2010/05/05/2010-10504/health-care-reform-insurance-web-portal-requirementshttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdfhttp://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdfhttps://www.federalregister.gov/articles/2012/03/27/2012-6125/patient-protection-and-affordable-care-act-establishment-of-exchanges-and-qualified-health-planshttps://www.federalregister.gov/articles/2012/03/27/2012-6125/patient-protection-and-affordable-care-act-establishment-of-exchanges-and-qualified-health-planshttps://www.federalregister.gov/articles/2012/03/27/2012-6125/patient-protection-and-affordable-care-act-establishment-of-exchanges-and-qualified-health-planshttp://www.irs.gov/3A%2F%2Fwww.gpo.gov%2Ffdsys%2Fpkg%2FFR-2012-04-30%2Fpdf%2F2012-10440.pdfhttp://www.irs.gov/3A%2F%2Fwww.gpo.gov%2Ffdsys%2Fpkg%2FFR-2012-04-30%2Fpdf%2F2012-10440.pdfhttp://www.irs.gov/3A%2F%2Fwww.gpo.gov%2Ffdsys%2Fpkg%2FFR-2012-04-30%2Fpdf%2F2012-10440.pdfhttp://www.irs.gov/3A%2F%2Fwww.gpo.gov%2Ffdsys%2Fpkg%2FFR-2012-04-30%2Fpdf%2F2012-10440.pdfhttp://www.irs.gov/3A%2F%2Fwww.gpo.gov%2Ffdsys%2Fpkg%2FFR-2012-04-30%2Fpdf%2F2012-10440.pdfhttps://www.federalregister.gov/articles/2012/03/27/2012-6125/patient-protection-and-affordable-care-act-establishment-of-exchanges-and-qualified-health-planshttps://www.federalregister.gov/articles/2012/03/27/2012-6125/patient-protection-and-affordable-care-act-establishment-of-exchanges-and-qualified-health-planshttp://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.federalregister.gov/articles/2010/05/05/2010-10504/health-care-reform-insurance-web-portal-requirementshttp://www.federalregister.gov/articles/2010/05/05/2010-10504/health-care-reform-insurance-web-portal-requirementshttps://www.federalregister.gov/articles/2012/03/21/2012-6728/early-retiree-reinsurance-program#p-3https://www.federalregister.gov/articles/2012/08/30/2012-21519/pre-existing-condition-insurance-plan-programhttp://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3http://www.federalregister.gov/articles/2011/06/24/2011-15890/group-health-plans-and-health-insurance-issuers-rules-relating-to-internal-claims-and-appeals-and#p-3


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November 19, 20123

Bulletin on the Transitional

Reinsurance Program: Proposed

Payment Operations by the

Department of Health and Human

Services

1341 ACA Guidance May 31, 2012 CCIIO

Patient Protection and AffordableCare Act; Standards Related to

Reinsurance, Risk Corridors and Risk

Adjustment

1341 ACA Final Rule March 23, 201277 Fed. Reg. 17220

May 22, 2012 HHS

Minimum Value of an Employer-

Sponsored Health Plan

1401 ACA IRS Notice 2012-31 April 26, 2012 June 11, 2012 IRS

Health Insurance Premium Tax

Credit

1412 ACA Rule May 23, 2012

77 Fed. Reg. 30377

August 21, 2012 May 23, 2012 IRS

Determining Full-Time Employeesfor Purposes of Shared

Responsibility for Employers

Regarding Health Coverage

1513 (4980H IRC) IRS Notice 2012-58 August 31, 2012 September 30,2012

IRS, HHS,DOL

Request for Comments on

Reporting by Applicable Large

Employers on Health Insurance

Coverage Under Employer-

Sponsored Plans

1514 ACA IRS Notice 2012-33 April 26, 2012 June 11, 2012 IRS

Medicare Program; Medicare

Shared Savings Program:

Accountable Care Organizations

3022 ACA Final Rule Nov. 2, 2011

76 Fed. Reg. 212, 67802

Jan. 1, 2011 CMS

Eligibility for a Medicare

Prescription Drug Subsidy -

Amendments to Regulations

3304 ACA Interim Final Rules

with Request for

Comments

Dec. 29, 2010

75 Fed. Reg. 249, 81843

Feb. 28, 2011 Jan. 1. 2011 SSA

Regulations Regarding Income-

Related Monthly Adjustment

Amounts to Medicare Beneficiaries

Prescription Drug Coverage

Premiums

3308 ACA Interim Final Rule with


Dec. 7, 2010 75 Fed.

Reg. 234, 75884

Feb. 7, 2011 Dec. 7, 2010 SSA
http://cciio.cms.gov/resources/files/reinsurance-program-bulletin-5-31-2012.pdfhttp://cciio.cms.gov/resources/files/reinsurance-program-bulletin-5-31-2012.pdfhttps://www.federalregister.gov/articles/2012/03/23/2012-6594/patient-protection-and-affordable-care-act-standards-related-to-reinsurance-risk-corridors-and-risk#p-3https://www.federalregister.gov/articles/2012/03/23/2012-6594/patient-protection-and-affordable-care-act-standards-related-to-reinsurance-risk-corridors-and-risk#p-3http://www.irs.gov/pub/irs-drop/n-12-31.pdfhttp://www.irs.gov/pub/irs-drop/n-12-31.pdfhttps://www.federalregister.gov/articles/2012/05/23/2012-12421/health-insurance-premium-tax-credithttps://www.federalregister.gov/articles/2012/05/23/2012-12421/health-insurance-premium-tax-credithttp://www.irs.gov/file_source/pub/irs-drop/n-12-58.pdfhttp://www.irs.gov/file_source/pub/irs-drop/n-12-58.pdfhttp://www.irs.gov/pub/irs-drop/n-12-33.pdfhttp://www.irs.gov/pub/irs-drop/n-12-33.pdfhttp://www.federalregister.gov/articles/2011/11/02/2011-27461/medicare-program-medicare-shared-savings-program-accountable-care-organizationshttp://www.federalregister.gov/articles/2011/11/02/2011-27461/medicare-program-medicare-shared-savings-program-accountable-care-organizationshttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-07/pdf/2010-30276.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-07/pdf/2010-30276.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-07/pdf/2010-30276.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-07/pdf/2010-30276.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-07/pdf/2010-30276.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-12-29/pdf/2010-32848.pdfhttp://www.federalregister.gov/articles/2011/11/02/2011-27461/medicare-program-medicare-shared-savings-program-accountable-care-organizationshttp://www.irs.gov/pub/irs-drop/n-12-33.pdfhttp://www.irs.gov/file_source/pub/irs-drop/n-12-58.pdfhttps://www.federalregister.gov/articles/2012/05/23/2012-12421/health-insurance-premium-tax-credithttp://www.irs.gov/pub/irs-drop/n-12-31.pdfhttps://www.federalregister.gov/articles/2012/03/23/2012-6594/patient-protection-and-affordable-care-act-standards-related-to-reinsurance-risk-corridors-and-risk#p-3http://cciio.cms.gov/resources/files/reinsurance-program-bulletin-5-31-2012.pdf


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November 19, 20124

Rate Increase Disclosure and

Review


Rulemaking

Dec. 23, 2010

75 Fed. Reg. 246, 81004

CCIIO

Grandfathered Plans - Group Health

Plans and Health Insurance

Coverage Rules Relating to Status

as a Grandfathered Health Plan

Under the Patient Protection and

Affordable Care Act


Rulemaking

Nov. 17, 2010 75 Fed.

Reg. 221, 70159

Dec. 17, 2010 IRS

Fees on Health Insurance Policies

and Self-Insured Plans for the

Patient-Centered Outcomes

Research Trust Fund; Hearing

Cancellation

6301 ACA Proposed Rule 77 Fed. Reg. 47573 Aug. 9, 2012 Aug. 8, 2012 IRS

*Please note: This document is current only as of the date listed below.*
http://edocket.access.gpo.gov/2010/pdf/2010-32143.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-32143.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-32143.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttps://www.federalregister.gov/articles/2012/08/09/2012-19585/fees-on-health-insurance-policies-and-self-insured-plans-for-the-patient-centered-outcomes-research#p-4https://www.federalregister.gov/articles/2012/08/09/2012-19585/fees-on-health-insurance-policies-and-self-insured-plans-for-the-patient-centered-outcomes-research#p-4https://www.federalregister.gov/articles/2012/08/09/2012-19585/fees-on-health-insurance-policies-and-self-insured-plans-for-the-patient-centered-outcomes-research#p-4http://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://www.gpo.gov/fdsys/pkg/FR-2010-11-17/pdf/2010-28866.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-32143.pdfhttp://edocket.access.gpo.gov/2010/pdf/2010-32143.pdf

Documents

Implementation of the Affordable Care Act