{"description":"Documents matching 'related mental health parity addiction'","count":186,"total_pages":10,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=related+mental+health+parity+addiction&format=json&page=2","results":[{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act","type":"Rule","abstract":"This document sets forth final rules amending regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and adding new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). Specifically, these final rules amend the existing NQTL standard to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from using NQTLs that place greater restrictions on access to mental health and substance use disorder benefits as compared to medical/surgical benefits. As part of these changes, these final rules require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on relevant outcomes related to access to mental health and substance use disorder benefits and medical/surgical benefits and to take reasonable action, as necessary, to address material differences in access to mental health or substance use disorder benefits as compared to medical/surgical benefits. These final rules also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the requirements of MHPAEA. Additionally, these final rules set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, the Departments), as well as to an applicable State authority, and to participants, beneficiaries, and enrollees. Finally, HHS finalizes regulatory amendments to implement the sunset provision for self-funded non-Federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023 (CAA, 2023).","document_number":"2024-20612","html_url":"https://www.federalregister.gov/documents/2024/09/23/2024-20612/requirements-related-to-the-mental-health-parity-and-addiction-equity-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-23/pdf/2024-20612.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-20612.pdf?1726258517","publication_date":"2024-09-23","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"ations/laws/<span class=\"match\">mental</span>-<span class=\"match\">health</span>-and-substance-use-disorder-<span class=\"match\">parity</span>/tools-and-resources \n and \n https://www.cms.gov/marketplace/private-<span class=\"match\">health</span>-insurance/<span class=\"match\">mental</span>-<span class=\"match\">health</span>-<span class=\"match\">parity</span>-<span class=\"match\">addiction</span>-equity. \n \n \n \n \n 21 \n  As discussed in more detail later in this preamble, NQTLs are generally non-numerical limits on the scope or duration of treatment, such as prior authorization requirements, step therapy, and standards <span class=\"match\">related</span> to network composition.\n \n \n \n In 1996, Congress enacted the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> Act of 1996 (MHPA 1996), which required <span class=\"match\">parity</span> in aggregate"},{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act; Extension of Comment Period","type":"Proposed Rule","abstract":"This document extends the comment period for the proposed rules entitled \"Requirements Related to the Mental Health Parity and Addiction Equity Act\" that were published in the August 3, 2023, issue of the Federal Register. The comment period for the proposed rules, which had been scheduled to close on October 2, 2023, is extended 15 days to October 17, 2023.","document_number":"2023-21177","html_url":"https://www.federalregister.gov/documents/2023/09/28/2023-21177/requirements-related-to-the-mental-health-parity-and-addiction-equity-act-extension-of-comment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-09-28/pdf/2023-21177.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-21177.pdf?1695818788","publication_date":"2023-09-28","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"Medicaid Services (CMS) website (\n www.cms.gov/cciio \n ), and information on <span class=\"match\">health</span> care reform can be found at \n www.Healthcare.gov \n or \n https://www.hhs.gov/healthcare/index.html. \n In addition, information about <span class=\"match\">mental</span> and behavioral <span class=\"match\">health</span> and <span class=\"match\">addiction</span> is available at \n https://www.samhsa.gov/<span class=\"match\">mental</span>-<span class=\"match\">health</span> \n and \n https://www.samhsa.gov/find-support. \n \n \n \n \n SUPPLEMENTARY INFORMATION: \n \n In the proposed rules, “Requirements <span class=\"match\">Related</span> to the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act,” released by the Departments of the Treasury, Labor, and HHS"},{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act","type":"Proposed Rule","abstract":"This document proposes amendments to regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and proposes new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). Specifically, these proposed rules would amend the existing NQTL standard to prevent plans and issuers from using NQTLs to place greater limits on access to mental health and substance use disorder benefits as compared to medical/ surgical benefits. As part of these changes, these proposed rules would require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on access to mental health and substance use disorder benefits and medical/surgical benefits, and would set forth a special rule with regard to network composition. These proposed rules would also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the protections of MHPAEA. Additionally, these proposed rules would set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, the Departments), as well as to an applicable State authority, and participants, beneficiaries, and enrollees. The Departments also solicit comments on whether there are ways to improve the coverage of mental health and substance use disorder benefits through other provisions of Federal law. Finally, HHS proposes regulatory amendments to implement the sunset provision for self-funded, non-Federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023 (CAA, 2023).","document_number":"2023-15945","html_url":"https://www.federalregister.gov/documents/2023/08/03/2023-15945/requirements-related-to-the-mental-health-parity-and-addiction-equity-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-08-03/pdf/2023-15945.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-15945.pdf?1690807523","publication_date":"2023-08-03","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"org/other/report/kff-cnn-<span class=\"match\">mental</span>-<span class=\"match\">health</span>-in-america-survey/ \n (showing half of adults say they have had a severe <span class=\"match\">mental</span> <span class=\"match\">health</span> crisis in their family); California <span class=\"match\">Health</span> Care Foundation, In Their Own Words: How Fragmented Care Harms People with Both <span class=\"match\">Mental</span> Illness and Substance Use Disorder, available at \n https://www.chcf.org/publication/fragmented-care-harms-people-<span class=\"match\">mental</span>-illness-substance-use-disorder/. \n \n \n \n Ensuring meaningful access to <span class=\"match\">mental</span> <span class=\"match\">health</span> and substance use disorder care is vital to addressing the Nation's <span class=\"match\">mental</span> <span class=\"match\">health</span> and substance use"},{"title":"Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request","type":"Notice","abstract":"On May 28, 2010, the Office of Management and Budget (OMB) issued Paperwork Reduction Act (PRA) guidance related to the \"generic\" clearance process. Generally, this is an expedited process by which agencies may obtain OMB's approval of collection of information requests that are \"usually voluntary, low-burden, and uncontroversial collections,\" do not raise any substantive or policy issues, and do not require policy or methodological review. The process requires the submission of an overarching plan that defines the scope of the individual collections that would fall under its umbrella. On October 23, 2011, OMB approved our initial request to use the generic clearance process under control number 0938-1148 (CMS-10398). It was last approved on April 26, 2021, via the standard PRA process which included the publication of 60- and 30-day Federal Register notices. The scope of the April 2021 umbrella accounts for Medicaid and CHIP State plan amendments, waivers, demonstrations, and reporting. This Federal Register notice seeks public comment on one or more of our collection of information requests that we believe are generic and fall within the scope of the umbrella. Interested persons are invited to submit comments regarding our burden estimates or any other aspect of this collection of information, including: the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.","document_number":"2025-22184","html_url":"https://www.federalregister.gov/documents/2025/12/08/2025-22184/medicaid-and-childrens-health-insurance-program-chip-generic-information-collection-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-08/pdf/2025-22184.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-22184.pdf?1764942312","publication_date":"2025-12-08","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"this collection contact: Rebecca Burch Mack at 303-844-7355.)\n \n \n 3. \n Title of Information Collection: \n Medicaid and the Children's <span class=\"match\">Health</span> Insurance Program (CHIP) <span class=\"match\">Parity</span> Tools; \n Type of Information Collection Request: \n New; \n Use: \n CMS has created a set of tools in the form of Excel workbook templates with accompanying instructions, both to assist states in complying with <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act requirements and to simplify and standardize collecting information for state and CMS review. The tools will be made available"},{"title":"CHAMPVA Coverage of Audio-Only Telehealth, Mental Health Services, and Cost Sharing for Certain Contraceptive Services and Contraceptive Products Approved, Cleared, or Granted by FDA","type":"Rule","abstract":"The Department of Veterans Affairs (VA) adopts as final, with changes, a proposed rule to amend its medical regulations regarding Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) coverage to remove the exclusion for audio-only telehealth, remove current quantitative limitations on mental health/ substance use disorder coverage, remove the current requirement for pre-authorization for outpatient mental health visits in excess of 23 per calendar year and/or more than two (2) sessions per week, and exempt certain contraceptive services and prescription and nonprescription contraceptive products that are approved, cleared, or granted by the U.S. Food and Drug Administration (FDA) from cost sharing requirements.","document_number":"2024-09072","html_url":"https://www.federalregister.gov/documents/2024/04/30/2024-09072/champva-coverage-of-audio-only-telehealth-mental-health-services-and-cost-sharing-for-certain","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-09072.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-09072.pdf?1714398257","publication_date":"2024-04-30","agencies":[{"raw_name":"DEPARTMENT OF VETERANS AFFAIRS","name":"Veterans Affairs Department","id":520,"url":"https://www.federalregister.gov/agencies/veterans-affairs-department","json_url":"https://www.federalregister.gov/api/v1/agencies/520","parent_id":null,"slug":"veterans-affairs-department"}],"excerpts":"appointments, \n i.e., \n inpatient and outpatient <span class=\"match\">mental</span> <span class=\"match\">health</span> services, residential treatment, institutional services for partial hospitalization, substance withdrawal management in a hospital setting or rehabilitation facility, outpatient SUD services, and family therapy for SUD. This would align the delivery of CHAMPVA <span class=\"match\">mental</span> <span class=\"match\">health</span>/SUD care with the Department of Defense (DoD) TRICARE program, current standards of practice in <span class=\"match\">mental</span> <span class=\"match\">health</span> and SUD care, and the goals of the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act of 2008. 87 FR at 64193. VA also"},{"title":"Supporting the Head Start Workforce and Consistent Quality Programming","type":"Rule","abstract":"This final rule makes regulatory changes to the Head Start Program Performance Standards (HSPPS) to support and stabilize the Head Start workforce and improve the quality of services Head Start programs provide to children and families. These changes include requirements for wages and benefits, breaks for staff, and enhanced support for staff health and wellness. The changes also include enhancements to mental health services to better integrate mental health into every aspect of program service delivery. Enhancements are also included in the areas of family service worker family assignments, identifying and meeting community needs, ensuring child safety, services for pregnant women and other pregnant people, and alignment with State early childhood systems. Finally, the changes include minor clarifications to promote better transparency and clarity of understanding for grant recipients.","document_number":"2024-18279","html_url":"https://www.federalregister.gov/documents/2024/08/21/2024-18279/supporting-the-head-start-workforce-and-consistent-quality-programming","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-21/pdf/2024-18279.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-18279.pdf?1723821314","publication_date":"2024-08-21","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"including, for example, <span class=\"match\">mental</span> <span class=\"match\">health</span> and staff benefits. In revising expectations around <span class=\"match\">mental</span> <span class=\"match\">health</span> consultation services, the final rule specifies that if a <span class=\"match\">mental</span> <span class=\"match\">health</span> consultant cannot be available to a program at least once a month, a program must supplement the work of a <span class=\"match\">mental</span> <span class=\"match\">health</span> consultant with other licensed <span class=\"match\">mental</span> <span class=\"match\">health</span> professionals or behavioral <span class=\"match\">health</span> support specialists certified and trained in their profession. This revision broadens the pool of available practitioners to provide programs with <span class=\"match\">mental</span> <span class=\"match\">health</span> supports in recognition"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Rule","abstract":"This final rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); requirements related to defrayal for the cost of any State-required benefits in addition to the EHB; cost- sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive plan years; QHP issuer quality improvement strategies (QISs); and revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States. This final rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-10050","html_url":"https://www.federalregister.gov/documents/2026/05/20/2026-10050/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-20/pdf/2026-10050.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-10050.pdf?1779135308","publication_date":"2026-05-20","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"890-4178, for matters <span class=\"match\">related</span> to civil money penalties of issuers and non-Federal governmental group <span class=\"match\">health</span> plans. \n Preeti Hans, (301) 492-5144, for matters <span class=\"match\">related</span> to the Quality Improvement Strategy. \n Mary Beth Hance, 410-786-4299, for matters <span class=\"match\">related</span> to the Basic <span class=\"match\">Health</span> Program. \n Christina Whitefield, (301) 492-4172, for matters <span class=\"match\">related</span> to the medical loss ratio (MLR) program. \n David Mlawsky, (410) 786-6851, for matters <span class=\"match\">related</span> to catastrophic plans with multi-year plan terms. \n Jessica Veffer, (301) 492-4827, for matters <span class=\"match\">related</span> to expanding hardship"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Proposed Rule","abstract":"This proposed rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This proposed rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); cost-sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive years; QHP issuer quality improvement strategies (QISs); revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States; and seeks comment on potential adjustments to other Federal standards, including the Federal medical loss ratio (MLR) standard in the individual market. This proposed rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-02769","html_url":"https://www.federalregister.gov/documents/2026/02/11/2026-02769/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-11/pdf/2026-02769.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02769.pdf?1770671709","publication_date":"2026-02-11","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"matters <span class=\"match\">related</span> to civil money penalties of issuers and non-Federal governmental group <span class=\"match\">health</span> plans. \n Preeti Hans, (301) 492-5144, for matters <span class=\"match\">related</span> to the Quality Improvement Strategy. \n Beth Freshcorn, (410) 786-3831, for matters <span class=\"match\">related</span> to administrative actions against agents, brokers, and web-brokers. \n Jennifer McIlvaine, (410) 786-0947, for matters <span class=\"match\">related</span> to the Basic <span class=\"match\">Health</span> Program. \n Christina Whitefield, (301) 492-4172, for matters <span class=\"match\">related</span> to the medical loss ratio (MLR) program. \n David Mlawsky, (410) 786-6851, for matters <span class=\"match\">related</span> to catastrophic"},{"title":"Excepted Fertility Benefits","type":"Proposed Rule","abstract":"This document contains proposed rules that would amend the regulations regarding excepted benefits under the Employee Retirement Income Security Act of 1974, the Internal Revenue Code, and the Public Health Service Act to establish certain fertility benefits as a new category of limited excepted benefits. Excepted benefits are generally exempt from the market requirements that were added to those laws by the Health Insurance Portability and Accountability Act, the Patient Protection and Affordable Care Act, the No Surprises Act, and certain other Federal laws specifically related to group health plans and group and individual health insurance coverage.","document_number":"2026-09479","html_url":"https://www.federalregister.gov/documents/2026/05/13/2026-09479/excepted-fertility-benefits","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-13/pdf/2026-09479.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-09479.pdf?1778589913","publication_date":"2026-05-13","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"and nondiscrimination rules with respect to <span class=\"match\">health</span> coverage. These provisions of the Code, ERISA, and the PHS Act were later augmented by other laws, including the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> Act of 1996; \n 2 \n \n the Newborns' and Mothers' <span class=\"match\">Health</span> Protection Act; \n 3 \n \n the Women's <span class=\"match\">Health</span> and Cancer Rights Act; \n 4 \n \n the Genetic Information Nondiscrimination Act of 2008; \n 5 \n \n the Paul Wellstone and Pete Domenici <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act of 2008 (MHPAEA); \n 6 \n \n the Children's <span class=\"match\">Health</span> Insurance Program Reauthorization Act of 2009; "},{"title":"Nondiscrimination in Health Programs and Activities","type":"Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding section 1557 of the Affordable Care Act (ACA) (section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of section 1557. The Department is also revising its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement. Additionally, the Department is revising provisions prohibiting discrimination on the basis of sex in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits (EHB); and qualified health plan issuers.","document_number":"2024-08711","html_url":"https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-06/pdf/2024-08711.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08711.pdf?1714162519","publication_date":"2024-05-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"the term “group <span class=\"match\">health</span> plan coverage” to refer to the underlying <span class=\"match\">health</span> coverage or benefits provided by the group <span class=\"match\">health</span> plan.\n \n \n \n Response: \n OCR is cognizant that <span class=\"match\">health</span> insurance issuers and group <span class=\"match\">health</span> plans develop their <span class=\"match\">health</span> insurance coverage and other <span class=\"match\">health</span>-<span class=\"match\">related</span> coverage benefit designs in advance of the plan year that the coverage is offered. Accordingly, we are including a delayed applicability date to the extent that the final rule's provisions require changes to <span class=\"match\">health</span> insurance coverage or other <span class=\"match\">health</span>-<span class=\"match\">related</span> coverage, including"},{"title":"Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Payment for Intensive Outpatient Services in Hospital Outpatient Departments, Community Mental Health Centers, Rural Health Clinics, Federally Qualified Health Centers, and Opioid Treatment Programs; Hospital Price Transparency; Changes to Community Mental Health Centers Conditions of Participation, Changes to the Inpatient Prospective Payment System Medicare Code Editor; Rural Emergency Hospital Conditions of Participation Technical Correction","type":"Rule","abstract":"This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for calendar year 2024 based on our continuing experience with these systems. In this final rule, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. Also, this final rule updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Rural Emergency Hospital Quality Reporting (REHQR) Program. In this final rule, we are also establishing a payment for certain intensive outpatient services under Medicare, beginning January 1, 2024. In addition, this final rule updates and refines requirements for hospitals to make public their standard charge information and enforcement of hospital price transparency. We are finalizing changes to the community mental health center (CMHC) Conditions of Participation (CoPs) to provide requirements for furnishing intensive outpatient (IOP) services, and we are finalizing the proposed personnel qualifications for mental health counselors (MHCs) and marriage and family therapists (MFTs). Additionally, we are finalizing the removal of discussion of the inpatient prospective payment system (IPPS) Medicare Code Editor (MCE) from the annual IPPS rulemakings, beginning with the fiscal year (FY) 2025 rulemaking. Finally, we are finalizing a technical correction to the Rural Emergency Hospital (REH) CoPs under the standard for the designation and certification of REHs.","document_number":"2023-24293","html_url":"https://www.federalregister.gov/documents/2023/11/22/2023-24293/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-11-22/pdf/2023-24293.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-24293.pdf?1698959177","publication_date":"2023-11-22","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"whether to pay for these specified <span class=\"match\">mental</span> <span class=\"match\">health</span> services individually, or to make a single payment at the same payment rate established for APC 5863 for all the specified <span class=\"match\">mental</span> <span class=\"match\">health</span> services furnished by the hospital on that single date of service. We continue to believe that the costs associated with administering a partial hospitalization program at a hospital represent the most resource intensive of all outpatient <span class=\"match\">mental</span> <span class=\"match\">health</span> services. \n \n We proposed that when the aggregate payment for specified <span class=\"match\">mental</span> <span class=\"match\">health</span> services provided by one hospital"},{"title":"Supporting the Head Start Workforce and Consistent Quality Programming","type":"Proposed Rule","abstract":"We propose to add new requirements to the Head Start Program Performance Standards (HSPPS) to support and stabilize the Head Start workforce, including requirements for wages and benefits, breaks for staff, and enhanced supports for staff health and wellness. We also propose to enhance several existing requirements and add new requirements to promote consistent quality of services across Head Start programs. This includes proposed enhancements to requirements for mental health services to better integrate these services into every aspect of programs as well as elevate the role of mental health consultation to support the well-being of children, families, and staff. Enhancements are also proposed in the areas of family service, worker family assignments, identifying and meeting community needs, ensuring child safety, services for pregnant women and people, and alignment with State early childhood systems. Finally, we propose minor clarifications to existing standards to promote better transparency and clarity of understanding for grant recipients.","document_number":"2023-25038","html_url":"https://www.federalregister.gov/documents/2023/11/20/2023-25038/supporting-the-head-start-workforce-and-consistent-quality-programming","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-11-20/pdf/2023-25038.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-25038.pdf?1700083040","publication_date":"2023-11-20","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Administration for Children and Families","name":"Children and Families Administration","id":49,"url":"https://www.federalregister.gov/agencies/children-and-families-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/49","parent_id":221,"slug":"children-and-families-administration"}],"excerpts":"ment-and-<span class=\"match\">mental</span>-<span class=\"match\">health</span>. \n \n \n \n We know that social-emotional difficulties impact up to 20 percent of children under the age of 5, and that over half of <span class=\"match\">mental</span> <span class=\"match\">health</span> disorders begin before age 14.\n 143 \n \n We also know that children and families experiencing poverty are more likely to encounter stressors linked to <span class=\"match\">mental</span> <span class=\"match\">health</span> challenges as well as experience barriers to accessing <span class=\"match\">mental</span> <span class=\"match\">health</span> services. Research findings specifically indicate that children and families living in high-poverty neighborhoods exhibit worse <span class=\"match\">mental</span> <span class=\"match\">health</span> outcomes"},{"title":"Proposed Collection; Comment Request for Notice of Medical Necessity Criteria Under the Mental Health Parity and Addiction Equity Act of 2008","type":"Notice","abstract":"The Department of the Treasury, as part of its continuing effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies to take this opportunity to comment on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of 1995. Currently, the IRS is soliciting comments concerning Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008.","document_number":"2022-13431","html_url":"https://www.federalregister.gov/documents/2022/06/23/2022-13431/proposed-collection-comment-request-for-notice-of-medical-necessity-criteria-under-the-mental-health","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-06-23/pdf/2022-13431.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-13431.pdf?1655901918","publication_date":"2022-06-23","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"}],"excerpts":"Necessity Criteria under the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act of 2008.\n \n \n OMB Number: \n 1545-2165.\n \n \n Abstract: \n This document contains previously approved final rules implementing the Paul Wellstone and Pete Domenici <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act (MHPAEA) of 2008, which requires <span class=\"match\">parity</span> between <span class=\"match\">mental</span> <span class=\"match\">health</span> or substance use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations under group <span class=\"match\">health</span> plans and group and individual <span class=\"match\">health</span> insurance coverage.\n \n \n"},{"title":"Agency Information Collection Activities: Submission for OMB Review; Comment Request","type":"Notice","abstract":"The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.","document_number":"2024-18745","html_url":"https://www.federalregister.gov/documents/2024/08/21/2024-18745/agency-information-collection-activities-submission-for-omb-review-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-21/pdf/2024-18745.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-18745.pdf?1724157942","publication_date":"2024-08-21","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"approved collection; \n Title of Information Collection: \n Medical Necessity and Claims Denial Disclosures under MHPAEA; \n Use: \n The Paul Wellstone and Pete Domenici <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act of 2008 (MHPAEA) (Pub. L. 110-343) generally requires that group <span class=\"match\">health</span> plans and group <span class=\"match\">health</span> insurance issuers offering both medical and surgical (med/surg) and <span class=\"match\">mental</span> <span class=\"match\">health</span> or substance use disorder (MH/SUD) benefits do not apply any more restrictive financial requirements (\n e.g., \n co-pays, deductibles) and/or treatment limitations ("},{"title":"Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicaid, Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, agent/broker compensation, health equity, drug coverage, dual eligible special needs plans (D-SNPs), utilization management, network adequacy, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This proposed rule also includes proposals to codify existing subregulatory guidance in the Part C and Part D programs.","document_number":"2024-27939","html_url":"https://www.federalregister.gov/documents/2024/12/10/2024-27939/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-10/pdf/2024-27939.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27939.pdf?1732656194","publication_date":"2024-12-10","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"the benefits need not be primarily <span class=\"match\">health</span> <span class=\"match\">related</span>, as described at § 422.100(c)(2)(ii)(A), and the MA organization must incur a non-zero direct non-administrative cost (as opposed to a non-zero medical cost) in covering the benefit. Further, while an SSBCI may be non-primarily <span class=\"match\">health</span> <span class=\"match\">related</span>, there must still be a reasonable expectation that the item or service will improve or maintain the <span class=\"match\">health</span> or overall function of the chronically ill enrollee. For example, an air conditioner is not a primarily <span class=\"match\">health</span> <span class=\"match\">related</span> item or service, but there is acceptable"},{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability","type":"Rule","abstract":"This final rule revises standards relating to denial of coverage for failure to pay past-due premium; excludes Deferred Action for Childhood Arrivals recipients from the definition of \"lawfully present;\" establishes the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; revises the Exchange automatic reenrollment hierarchy; revises standards related to the annual open enrollment period and special enrollment periods; revises standards relating to failure to file and reconcile, income eligibility verifications for premium tax credits and cost-sharing reductions, annual eligibility redeterminations, de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements, and income-based cost-sharing reduction plan variations. This final rule also revises the premium adjustment percentage methodology and prohibits issuers of coverage subject to EHB requirements from providing coverage for specified sex-trait modification procedures as an EHB.","document_number":"2025-11606","html_url":"https://www.federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-06-25/pdf/2025-11606.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-11606.pdf?1750709712","publication_date":"2025-06-25","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"shared that increasing access to <span class=\"match\">health</span> insurance coverage and <span class=\"match\">health</span> care has positive impacts on individual and \n \n population <span class=\"match\">health</span>, and, conversely, that decreasing access to coverage harms individual and population <span class=\"match\">health</span>.\n 49 \n \n Many commenters stated that they expected the provision would result in decreased community public <span class=\"match\">health</span> and decreased well-being for DACA recipients as these individuals become uninsured, noting that leaving thousands of DACA recipients without <span class=\"match\">health</span> coverage could lead to dire <span class=\"match\">health</span> consequences in their communities"},{"title":"Semiannual Agenda","type":"Proposed Rule","abstract":"This notice is given pursuant to the requirements of the Regulatory Flexibility Act and Executive Order 12866 (\"Regulatory Planning and Review\"), as amended, which require the publication by the Department of a semiannual agenda of regulations.","document_number":"2024-16461","html_url":"https://www.federalregister.gov/documents/2024/08/16/2024-16461/semiannual-agenda","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-16/pdf/2024-16461.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-16461.pdf?1723725921","publication_date":"2024-08-16","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"}],"excerpts":"\n \n \n DEPARTMENT OF THE TREASURY (TREAS) \n \n Internal Revenue Service (IRS) \n Final Rule Stage \n 192. <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act and the Consolidated Appropriations Act, 2021 [1545-BQ29] \n \n Legal Authority: \n 26 U.S.C. 7805; Pub. L. 116-260, Division BB, Title II; Pub. L. 110-343, secs. 511-512\n \n \n Abstract: \n This rule would finalize proposed amendments to the final rules implementing the <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act (MHPAEA). The amendments clarify plans' and issuers' obligations under the law, promote compliance"},{"title":"Agency Information Collection Activities: Proposed Collection; Comment Request","type":"Notice","abstract":"The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.","document_number":"2024-10900","html_url":"https://www.federalregister.gov/documents/2024/05/17/2024-10900/agency-information-collection-activities-proposed-collection-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-17/pdf/2024-10900.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-10900.pdf?1715863532","publication_date":"2024-05-17","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"approved collection; \n Title of Information Collection: \n Medical Necessity and Claims Denial Disclosures under MHPAEA; \n Use: \n The Paul Wellstone and Pete Domenici <span class=\"match\">Mental</span> <span class=\"match\">Health</span> <span class=\"match\">Parity</span> and <span class=\"match\">Addiction</span> Equity Act of 2008 (MHPAEA) (Pub. L.110-343) generally requires that group <span class=\"match\">health</span> plans and group <span class=\"match\">health</span> insurance issuers offering both medical and surgical (med/surg) and <span class=\"match\">mental</span> <span class=\"match\">health</span> or substance use disorder (MH/SUD) benefits do not apply any more restrictive financial requirements (\n e.g., \n co-pays, deductibles) and/or treatment limitations ("},{"title":"Medicaid Program; Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality","type":"Rule","abstract":"This final rule will advance CMS's efforts to improve access to care, quality and health outcomes, and better address health equity issues for Medicaid and Children's Health Insurance Program (CHIP) managed care enrollees. The final rule addresses standards for timely access to care and States' monitoring and enforcement efforts, reduces State burdens for implementing some State directed payments (SDPs) and certain quality reporting requirements, adds new standards that will apply when States use in lieu of services and settings (ILOSs) to promote effective utilization and that specify the scope and nature of ILOSs, specifies medical loss ratio (MLR) requirements, and establishes a quality rating system for Medicaid and CHIP managed care plans.","document_number":"2024-08085","html_url":"https://www.federalregister.gov/documents/2024/05/10/2024-08085/medicaid-program-medicaid-and-childrens-health-insurance-program-chip-managed-care-access-finance","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-10/pdf/2024-08085.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08085.pdf?1713816918","publication_date":"2024-05-10","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"behavioral <span class=\"match\">health</span> PIHP; therefore, a State will not be required to set appointment wait time standards for primary care and OB/GYN providers for the behavioral <span class=\"match\">health</span> PIHP and will only have to set appointment wait time standards for <span class=\"match\">mental</span> <span class=\"match\">health</span> and SUD providers, as well as one State-selected provider type. To ensure that our proposal to have States set appointment wait time standards for <span class=\"match\">mental</span> <span class=\"match\">health</span> and SUD, as well as one State-selected provider type for behavioral PIHPs and PAHPs is feasible, we requested comment on whether behavioral <span class=\"match\">health</span> PIHPs"},{"title":"Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities","type":"Rule","abstract":"This final rule with comment period revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2025 based on our continuing experience with these systems. We describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. Also, this final rule updates the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, and Hospital Inpatient Quality Reporting Program. We also summarize information received in response to a Request for Information on potential modifications to the Safety of Care measure group in the Overall Hospital Quality Star Rating methodology. In this final rule, we are also finalizing our proposal to narrow the description of \"custody\" in the Medicare payment exclusion rule and to revise the special enrollment period criteria for formerly incarcerated individuals. We are also finalizing our Medicaid and Children's Health Insurance Program (CHIP) continuous eligibility provisions. We are also finalizing the proposal to reduce the review timeframe for standard prior authorization requests for certain covered outpatient department services paid under the OPPS from 10-business days to 7-calendar days. Further, this rule finalizes updates to the Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs) in an effort to advance the health and safety of pregnant, birthing, and postpartum women. This rule also finalizes our proposed policy to separately pay Indian Health Service (IHS) and Tribal hospitals for high-cost drugs furnished in hospital outpatient departments through an add-on payment in addition to the all-inclusive rate (AIR) under the authorities used to calculate the AIR starting January 1, 2025. Finally, we are finalizing exceptions to the Medicaid clinic services four walls requirement for IHS and Tribal clinics, and, at state option, for behavioral health clinics and clinics located in rural areas.","document_number":"2024-25521","html_url":"https://www.federalregister.gov/documents/2024/11/27/2024-25521/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25521.pdf?1730492130","publication_date":"2024-11-27","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"three new HCPCS codes for Digital <span class=\"match\">Mental</span> <span class=\"match\">Health</span> Treatment Devices (DHMT): GMBT1 (\n Supply of digital <span class=\"match\">mental</span> <span class=\"match\">health</span> treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan \n ) for furnishing a DMHT device; GMBT2 (\n \n First 20 \n \n minutes of monthly treatment management services directly <span class=\"match\">related</span> to the patient's therapeutic use of the digital <span class=\"match\">mental</span> <span class=\"match\">health</span> treatment (DMHT) device that augments a behavioral therapy plan, physician/other qualified <span class=\"match\">health</span> care professional time reviewing data"}]}