Legislation Ending Government Shutdown Includes Eligibility Verification Requirements for Premium Tax Credits and Cost-sharing Reductions | Practical Law
The President has signed into law the Continuing Appropriations Act, 2014, which includes an eligibility verification requirement for health insurance premium tax credits and cost-sharing subsidies relating to the health insurance exchanges (now referred to as "marketplaces") under the Affordable Care Act (ACA).
On October 17, 2013, the President signed into law the Continuing Appropriations Act, 2014 (CAA), which makes continuing appropriations through January 15, 2014, thereby ending the partial shutdown of the federal government's operations, and increases the debt limit through February 7, 2014. The CAA includes an eligibility verification requirement for health insurance premium tax credits and cost-sharing subsidies relating to the health insurance exchanges (now referred to as "marketplaces") under the Affordable Care Act (ACA).
The CAA requires the Secretary of HHS to ensure that exchanges verify that applicants for tax credits and cost-sharing meet the eligibility requirements under Section 1411 of the Patient Protection and Affordable Care Act (PPACA) (42 U.S.C. § 18081). The CAA also requires HHS, before making tax credits and cost-sharing available to applicants, to certify to Congress that the exchanges are carrying out eligibility verification consistent with the ACA.
The CAA also requires two reports from HHS relating to these eligibility verification procedures. The HHS Secretary must submit a report to Congress by January 1, 2014 detailing procedures that the exchanges will use to verify eligibility for tax credits and cost-sharing. In addition, by July 1, 2014, HHS' Inspector General must submit a report to Congress regarding the effectiveness of procedures under the ACA for preventing submission of inaccurate or fraudulent information by exchange applicants.