{"description":"Documents matching 'security self-insured operators must provide'","count":93,"total_pages":5,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=security+self-insured+operators+must+provide&format=json&page=2","results":[{"title":"Black Lung Benefits Act: Authorization of Self-Insurers","type":"Rule","abstract":"This final rule revises the regulations under the Black Lung Benefits Act (BLBA) governing authorization of self-insurers. The updated regulations determine the process for coal mine operators to apply for authorization to self-insure, the requirements operators must meet to qualify to self-insure, the amount of security self-insured operators must provide, and the process for operators to appeal determinations made by the Office of Workers' Compensation Programs (OWCP).","document_number":"2024-28848","html_url":"https://www.federalregister.gov/documents/2024/12/12/2024-28848/black-lung-benefits-act-authorization-of-self-insurers","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-12/pdf/2024-28848.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-28848.pdf?1733924724","publication_date":"2024-12-12","agencies":[{"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":"Office of Workers' Compensation Programs","name":"Workers' Compensation Programs Office","id":530,"url":"https://www.federalregister.gov/agencies/workers-compensation-programs-office","json_url":"https://www.federalregister.gov/api/v1/agencies/530","parent_id":271,"slug":"workers-compensation-programs-office"}],"excerpts":"including the requirement for increased security from self-insured operators. They noted that Congress intended coal-mine operators to bear the cost of black lung disease, and that they should provide enough security to protect the Trust Fund, and ultimately, taxpayers, from any operator bankruptcy. \n Other commenters argued the changes will negatively impact self-insured operators. Most of these negative comments asserted that self-insured operators would face too high a financial burden if required to post security equal to 120 percent of their projected"},{"title":"Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure","type":"Proposed Rule","abstract":"The Department is proposing a regulation that would require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). These disclosures are needed so that fiduciaries can assess the reasonableness of the contracts or arrangements with these service providers, including the reasonableness of the service providers' compensation. These disclosure requirements would apply for purposes of ERISA's statutory prohibited transaction exemption for services arrangements. This proposal implements section 12 of President Trump's Executive Order 14273, Lowering Drug Prices by Once Again Putting Americans First, which instructs the Department to propose regulations to improve employer health plan transparency into the direct and indirect compensation received by pharmacy benefit managers. If finalized, this regulation would affect sponsors and other fiduciaries of self-insured group health plans and certain service providers to such plans.","document_number":"2026-01907","html_url":"https://www.federalregister.gov/documents/2026/01/30/2026-01907/improving-transparency-into-pharmacy-benefit-manager-fee-disclosure","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-30/pdf/2026-01907.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-01907.pdf?1769721310","publication_date":"2026-01-30","agencies":[{"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"}],"excerpts":"plan fiduciary for the self-insured group health plan would receive the disclosures from the party that contracts with the self-insured group health plan to provide pharmacy benefit management services. In the case of a MEWA that is not considered a single ERISA plan, but rather involves a number of self-insured group health plans each sponsored by an employer individually, the party operating the MEWA is likely to be the covered service provider that contracts with the individual self-insured group health plans to provide pharmacy benefit management"},{"title":"Black Lung Benefits Act: Authorization of Self-Insurers","type":"Proposed Rule","abstract":"The Department of Labor is extending the comment period for a proposed rule that would update the process for coal mine operators to apply for authorization to self-insure, the requirements operators must meet to qualify to self-insure, the amount of security self-insured operators must provide, and the process for operators to appeal determinations made by the Office of Workers' Compensation Programs (OWCP). Since the proposed rule was published, the Department has received multiple requests from interested parties for the Department to provide additional time for them to develop and submit their comments on the proposal. In response to those requests, the Department is extending the comment period.","document_number":"2023-04322","html_url":"https://www.federalregister.gov/documents/2023/03/07/2023-04322/black-lung-benefits-act-authorization-of-self-insurers","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-03-07/pdf/2023-04322.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-04322.pdf?1678110315","publication_date":"2023-03-07","agencies":[{"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":"Office of Workers Compensation Programs","name":"Workers' Compensation Programs Office","id":530,"url":"https://www.federalregister.gov/agencies/workers-compensation-programs-office","json_url":"https://www.federalregister.gov/api/v1/agencies/530","parent_id":271,"slug":"workers-compensation-programs-office"}],"excerpts":"a proposed rule that would update the process for coal mine operators to apply for authorization to self-insure, the requirements operators must meet to qualify to self-insure, the amount of security self-insured operators must provide, and the process for operators to appeal determinations made by the Office of Workers' Compensation Programs (OWCP). Since the proposed rule was published, the Department has received multiple requests from interested parties for the Department to provide additional time for them to develop and submit their comments"},{"title":"Black Lung Benefits Act: Authorization of Self-Insurers","type":"Proposed Rule","abstract":"The Department is proposing revisions to regulations under the Black Lung Benefits Act (BLBA or the Act) governing authorization of self-insurers. These proposed rules will determine the process for coal mine operators to apply for authorization to self-insure, the requirements operators must meet to qualify to self-insure, the amount of security self-insured operators must provide, and the process for operators to appeal determinations made by the Office of Workers' Compensation Programs (OWCP).","document_number":"2023-00534","html_url":"https://www.federalregister.gov/documents/2023/01/19/2023-00534/black-lung-benefits-act-authorization-of-self-insurers","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-01-19/pdf/2023-00534.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-00534.pdf?1674049513","publication_date":"2023-01-19","agencies":[{"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":"Office of Workers' Compensation Programs","name":"Workers' Compensation Programs Office","id":530,"url":"https://www.federalregister.gov/agencies/workers-compensation-programs-office","json_url":"https://www.federalregister.gov/api/v1/agencies/530","parent_id":271,"slug":"workers-compensation-programs-office"}],"excerpts":"self-insurers. These proposed rules will determine the process for coal mine operators to apply for authorization to self-insure, the requirements operators must meet to qualify to self-insure, the amount of security self-insured operators must provide, and the process for operators to appeal determinations made by the Office of Workers' Compensation Programs (OWCP). \n \n \n DATES: \n The Department invites written comments on the proposed regulations from interested parties. Written comments must be received by March 20, 2023. \n \n \n ADDRESSES: \n You may submit"},{"title":"Definition of “Employer”-Association Health Plans","type":"Rule","abstract":"This document rescinds the Department of Labor's (Department or DOL) 2018 rule entitled \"Definition of Employer Under Section 3(5) of ERISA--Association Health Plans\" (2018 AHP Rule). The 2018 AHP Rule established an alternative set of criteria from those set forth in the Department's pre-2018 AHP Rule (pre-rule) guidance for determining when a group or association of employers is acting \"indirectly in the interest of an employer\" under section 3(5) of the Employee Retirement Income Security Act of 1974 (ERISA) for purposes of establishing an association health plan (AHP) as a multiple employer group health plan. The 2018 AHP Rule was a significant departure from the Department's longstanding pre-rule guidance on the definition of \"employer\" under ERISA. This departure substantially weakened the Department's traditional criteria in a manner that would have enabled the creation of commercial AHPs functioning effectively as health insurance issuers. The Department now believes that the core provisions of the 2018 AHP Rule are, at a minimum, not consistent with the best reading of ERISA's statutory requirements governing group health plans.","document_number":"2024-08985","html_url":"https://www.federalregister.gov/documents/2024/04/30/2024-08985/definition-of-employer-association-health-plans","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-08985.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08985.pdf?1714398255","publication_date":"2024-04-30","agencies":[{"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"}],"excerpts":"association acting as an employer must \n exist \n for purposes \n other than \n providing health benefits. Instead, the 2018 AHP Rule only required that the group or association must have at least one substantial business purpose unrelated to offering and providing health coverage or other employee benefits to its employer members and their employees. In a significant departure from pre-rule guidance, the rule specifically stated that “the primary purpose of the group or association” could be “to offer and provide health coverage to its employer members"},{"title":"Definition of “Employer”-Association Health Plans","type":"Proposed Rule","abstract":"This document proposes to rescind the Department of Labor's (Department or DOL) 2018 rule entitled \"Definition of Employer-- Association Health Plans\" (2018 AHP Rule). The 2018 AHP Rule establishes an alternative set of criteria from those set forth in the Department's pre-rule guidance for determining when a group or association of employers is acting \"indirectly in the interest of an employer\" under section 3(5) of the Employee Retirement Income Security Act of 1974 (ERISA) for purposes of establishing an association health plan (AHP) as a multiple employer group health plan. The 2018 AHP Rule's alternative criteria were set aside in large part by the U.S. District Court for the District of Columbia in New York v. United States Department of Labor. The district court found the bona fide association and working owner provisions in the rule to be an unreasonable interpretation of ERISA, inconsistent with congressional intent that ERISA applies to employee benefits arising out of employment relationships. The Department, after further review of the relevant statutory language, judicial decisions, and pre-rule guidance, and further consideration of ERISA's statutory purposes and related policy goals, now proposes to rescind in full the 2018 AHP Rule in order to resolve and mitigate any uncertainty regarding the status of the standards that were set under the 2018 AHP Rule, allow for a reexamination of the criteria for a group or association of employers to be able to sponsor an AHP, and ensure that guidance being provided to the regulated community is in alignment with ERISA's text, purposes, and policies.","document_number":"2023-27510","html_url":"https://www.federalregister.gov/documents/2023/12/20/2023-27510/definition-of-employer-association-health-plans","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-12-20/pdf/2023-27510.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-27510.pdf?1702993520","publication_date":"2023-12-20","agencies":[{"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"}],"excerpts":" While paragraph (b)(1) of the 2018 AHP Rule provided that “the primary purpose of the group or association” could be “to offer and provide health coverage to its employer members and their employees,” the pre-rule guidance requires that the group or association acting as an employer must exist for purposes \n other than \n providing health benefits. The 2018 AHP Rule required that “the group or association also must have at least one substantial business purpose unrelated to offering and providing health coverage or other employee benefits to its"},{"title":"Longshore and Harbor Workers' Compensation Act: Civil Money Penalties Procedures","type":"Proposed Rule","abstract":"The Office of Workers' Compensation Programs (OWCP) administers the Longshore and Harbor Workers' Compensation Act and its extensions. To promote accountability and ensure fairness, OWCP proposes new rules for imposing and reviewing civil money penalties prescribed by the Longshore Act. The proposed rules would also set forth the procedures to contest OWCP's penalty determinations.","document_number":"2023-19422","html_url":"https://www.federalregister.gov/documents/2023/09/12/2023-19422/longshore-and-harbor-workers-compensation-act-civil-money-penalties-procedures","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-09-12/pdf/2023-19422.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-19422.pdf?1694436317","publication_date":"2023-09-12","agencies":[{"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":"Office of Workers' Compensation Programs","name":"Workers' Compensation Programs Office","id":530,"url":"https://www.federalregister.gov/agencies/workers-compensation-programs-office","json_url":"https://www.federalregister.gov/api/v1/agencies/530","parent_id":271,"slug":"workers-compensation-programs-office"}],"excerpts":"Workers' Compensation Programs, U.S. Department of Labor, Room S-3229, 200 Constitution Avenue NW, Washington, DC 20210. The Department's receipt of U.S. mail may be significantly delayed due to security procedures. You must take this into consideration when preparing to meet the deadline for submitting comments.\n \n \n Instructions: \n All submissions received must include the agency name and the Regulatory Information Number (RIN) for this rulemaking. All comments received will be posted without change to \n https://www.regulations.gov. \n Please do not"},{"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":"Affordable Care Act provides for, among other things, reductions in cost sharing for EHB for qualified low- and moderate-income enrollees in silver level QHPs offered through the individual market Exchanges. This section also provides for reductions in cost sharing for American Indians and Alaska Natives (AI/AN) enrolled in QHPs at any metal level. \n Section 1411(f) of the Affordable Care Act requires the Secretary, in consultation with the Secretary of the Treasury and the Secretary of Homeland Security, and the Commissioner of Social Security, to establish"},{"title":"Department of Energy Acquisition Regulation (DEAR)","type":"Rule","abstract":"The Department of Energy (DOE or the Department) is publishing a final rule comprehensively revising its Acquisition Regulation in order to update and streamline the policies, procedures, provisions and clauses that are applicable to the Department's contracts. This rulemaking updates or eliminates coverage that is obsolete or that unnecessarily duplicates the Federal Acquisition Regulation (FAR) and retains only that coverage which either implements or supplements the FAR for the award and administration of the DOE's contracts. The rule adds several new clauses and amends several existing clauses in order to promote more uniform application of the DOE's contract award and administration policies.","document_number":"2024-23817","html_url":"https://www.federalregister.gov/documents/2024/11/13/2024-23817/department-of-energy-acquisition-regulation-dear","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-13/pdf/2024-23817.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-23817.pdf?1731419115","publication_date":"2024-11-13","agencies":[{"raw_name":"DEPARTMENT OF ENERGY","name":"Energy Department","id":136,"url":"https://www.federalregister.gov/agencies/energy-department","json_url":"https://www.federalregister.gov/api/v1/agencies/136","parent_id":null,"slug":"energy-department"}],"excerpts":"required to be reported to the Securities and Exchange Commission, the Federal Trade Commission, or the Department of Justice, shall also be furnished concurrently to the Contracting Officer and to the cognizant security office.\n \n (2) If a Contractor has changes involving FOCI, DOE must determine whether the changes will pose an undue risk to the common defense and security. In making this determination, DOE will consider proposals made by the Contractor to avoid or mitigate foreign influences. \n (3) If the cognizant security office at any time determines"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2025; Updating Section 1332 Waiver Public Notice Procedures; Medicaid; Consumer Operated and Oriented Plan (CO-OP) Program; and Basic Health Program","type":"Rule","abstract":"This final rule includes payment parameters and provisions related to the HHS-operated risk adjustment program, as well as 2025 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 requirements related to the auto re-enrollment hierarchy; essential health benefits; failure to file Federal income taxes to reconcile advance payments of the premium tax credit (APTC); non- standardized plan option limits in the FFEs and SBE-FPs and a related exceptions process; standardized plan options in the FFEs and SBE-FPs; special enrollment periods (SEPs); direct enrollment (DE) entities supporting Exchange applications and enrollments; the Insurance Affordability Program enrollment eligibility verification process; requirements for agents, brokers, web-brokers, and DE entities assisting Exchange consumers; network adequacy; public notice procedures for section 1332 waivers; prescription drug benefits; updates to the Consumer Operated and Oriented Plan (CO-OP) Program; and State flexibility on the effective date of coverage in the Basic Health Program (BHP).","document_number":"2024-07274","html_url":"https://www.federalregister.gov/documents/2024/04/15/2024-07274/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2025","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-15/pdf/2024-07274.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07274.pdf?1712351231","publication_date":"2024-04-15","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":"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":"Secretary of the Treasury. Section 1411(d) of the ACA provides that the Secretary must verify the accuracy of information provided by applicants under section 1411(b) of the ACA, for which section 1411(c) of the ACA does not prescribe a specific verification procedure, in such manner as the Secretary determines appropriate. \n Section 1411(f) of the ACA requires the Secretary, in consultation with the Secretary of the Treasury and the Secretary of Homeland Security, and the Commissioner of Social Security, to establish procedures for hearing and making"},{"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026; and Basic Health Program","type":"Proposed Rule","abstract":"This proposed rule includes payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2026 benefit year user fee rates for issuers that participate in the HHS-operated risk adjustment program and the 2026 benefit year 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 proposed requirements related to modifications to the calculation of the Basic Health Program (BHP) payment; and changes to the Initial Validation Audit (IVA) sampling approach and Second Validation Audit (SVA) pairwise means test for HHS- RADV. It also addresses HHS' authority to engage in compliance reviews of and take enforcement action against lead agents of insurance agencies for violations of HHS' Exchange standards and requirements; HHS' system suspension authority to address noncompliance by agents and brokers; an optional fixed-dollar premium payment threshold; proposed reconsideration standards for certification denials; proposed changes to the approach for conducting Essential Community Provider (ECP) certification reviews; a proposal to publicly share aggregated, summary-level Quality Improvement Strategy (QIS) information on an annual basis; and proposed revisions to the medical loss ratio (MLR) reporting and rebate requirements for qualifying issuers that meet certain standards.","document_number":"2024-23103","html_url":"https://www.federalregister.gov/documents/2024/10/10/2024-23103/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2026-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-10/pdf/2024-23103.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-23103.pdf?1728072923","publication_date":"2024-10-10","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"},{"raw_name":"Office of the Secretary"}],"excerpts":"the year. \n Section 1402 of the ACA provides for, among other things, reductions in cost sharing for EHB for qualified low- and moderate-income enrollees in silver level QHPs offered through the individual market Exchanges. This section also provides for reductions in cost sharing for Indians enrolled in QHPs at any metal level. \n Section 1411(f) of the ACA requires the Secretary, in consultation with the Secretary of the Treasury and the Secretary of Homeland Security, and the Commissioner of Social Security, to establish procedures for hearing"},{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability","type":"Proposed Rule","abstract":"This proposed rule would revise standards relating to past-due premium payments; exclude Deferred Action for Childhood Arrivals recipients from the definition of \"lawfully present\"; the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; failure to file and reconcile; income eligibility verifications for premium tax credits and cost-sharing reductions; annual eligibility redetermination; the automatic reenrollment hierarchy; the annual open enrollment period; special enrollment periods; de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements and for income-based cost-sharing reduction plan variations; and the premium adjustment percentage methodology; and prohibit issuers of coverage subject to EHB requirements from providing coverage for sex-trait modification as an EHB.","document_number":"2025-04083","html_url":"https://www.federalregister.gov/documents/2025/03/19/2025-04083/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-03-19/pdf/2025-04083.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-04083.pdf?1741810509","publication_date":"2025-03-19","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":"the case with the long-established net percentage-based threshold, under which enrollees must always pay at least some premium to avoid delinquency or loss of coverage (in cases where the premium is not covered 100 percent by APTC).\n \n \n \n 103 \n Per § 156.270(f), if an enrollee is delinquent on premium payment, the QHP issuer must provide the enrollee with notice of such payment delinquency. Issuers offering QHPs in Exchanges on the Federal platform must provide such notices promptly and without undue delay, within 10 business days of the date the"},{"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026; and Basic Health Program","type":"Rule","abstract":"This final rule includes payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2026 benefit year user fee rates for issuers that participate in the HHS-operated risk adjustment program and the 2026 benefit year 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 requirements related to modifications to the calculation of the Basic Health Program (BHP) payment; and changes to the Initial Validation Audit (IVA) sampling approach and Second Validation Audit (SVA) pairwise means test for HHS-RADV. It also addresses HHS' authority to engage in compliance reviews of and take enforcement action against lead agents of insurance agencies for violations of HHS' Exchange standards and requirements; HHS' system suspension authority to address noncompliance by agents and brokers; an optional fixed-dollar premium payment threshold; permissible plan-level adjustment to the index rate to account for cost-sharing reductions (CSRs); reconsideration standards for certification denials; changes to the approach for conducting Essential Community Provider (ECP) certification reviews; a policy to publicly share aggregated, summary- level Quality Improvement Strategy (QIS) information on an annual basis; and revisions to the medical loss ratio (MLR) reporting and rebate requirements for qualifying issuers that meet certain standards.","document_number":"2025-00640","html_url":"https://www.federalregister.gov/documents/2025/01/15/2025-00640/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2026-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-15/pdf/2025-00640.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-00640.pdf?1736802922","publication_date":"2025-01-15","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":"Office of the Secretary"}],"excerpts":"to provide a direct FTR notification to their consumers would be overly burdensome.\n \n \n Response: \n We understand the concern raised by commenters regarding increased burden for Exchanges to provide these FTR notifications. However, States have flexibility under § 155.305(f)(4)(ii)(B) to provide either a direct notice that discloses FTI or an indirect notice that does not disclose FTI to their consumers, and we are not requiring Exchanges to provide direct notices in this final rule.\n \n \n Comment: \n One commenter requested that HHS provide technical"},{"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":"320(c)(3) are not duplicative of the existing rules under § 155.315(c)(2). Section 155.315(c)(2) provides that, for applicants who attest to having a lawfully present status, the Exchange must verify their lawful presence through the Department of Homeland Security (DHS) to determine eligibility for enrollment in a QHP. The new regulations at § 155.320(c)(3) provide that, for applicants who attest to having an eligible noncitizen status, the Exchange must verify their eligible noncitizen status through DHS to determine eligibility for APTC. These requirements"},{"title":"Introduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions-Fall 2023","type":"Proposed Rule","abstract":"Publication of the Fall 2023 Unified Agenda of Federal Regulatory and Deregulatory Actions represents a key component of the regulatory planning mechanism prescribed in Executive Order (\"E.O.\") 12866, \"Regulatory Planning and Review,\" (58 FR 51735, as amended) and reaffirmed in E.O. 13563, \"Improving Regulation and Regulatory Review,\" (76 FR 3821) and E.O. 14094, \"Modernizing Regulatory Review,\" (88 FR 21879). The Regulatory Flexibility Act requires that agencies publish semiannual regulatory agendas in the Federal Register describing regulatory actions they are developing that may have a significant economic impact on a substantial number of small entities (5 U.S.C. 602). The Unified Agenda of Federal Regulatory and Deregulatory Actions (Unified Agenda), published in the fall and spring, helps agencies fulfill all of these requirements. All Federal regulatory agencies have chosen to publish their regulatory agendas as part of this publication. The complete publication of the Fall 2023 Unified Agenda contains the Regulatory Plans of 29 Federal agencies and 69 Federal agency regulatory agendas available to the public at www.reginfo.gov. The Fall 2023 Unified Agenda publication appearing in the Federal Register includes the Regulatory Plan and agency Regulatory Flexibility Agendas, in accordance with the publication requirements of the Regulatory Flexibility Act. Agency Regulatory Flexibility Agendas contain only those Agenda entries for rules that are likely to have a significant economic impact on a substantial number of small entities and entries that have been selected for periodic review under section 610 of the Regulatory Flexibility Act.","document_number":"2024-00476","html_url":"https://www.federalregister.gov/documents/2024/02/09/2024-00476/introduction-to-the-unified-agenda-of-federal-regulatory-and-deregulatory-actions-fall-2023","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-09/pdf/2024-00476.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-00476.pdf?1707399919","publication_date":"2024-02-09","agencies":[{"raw_name":"REGULATORY INFORMATION SERVICE CENTER","name":"Regulatory Information Service Center","id":449,"url":"https://www.federalregister.gov/agencies/regulatory-information-service-center","json_url":"https://www.federalregister.gov/api/v1/agencies/449","parent_id":null,"slug":"regulatory-information-service-center"}],"excerpts":"information and costs of security measures that support updating the HIPAA Security Rule to help ensure that it can continue to provide a baseline of security standards to meet current and emerging security risks and threats to ePHI.\n \n \n Alternatives: \n HHS considered whether these policy updates could be implemented through guidance. However, the Department determined that this would be insufficient to prevent and address cybersecurity threats and vulnerabilities facing the U.S. health care system. Revisions to the existing HIPAA Security Rule will help"},{"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":"the case with the long-established net percentage-based threshold, under which enrollees must always pay at least some premium to avoid delinquency or loss of coverage (in cases where the premium is not covered 100 percent by APTC).\n \n \n \n 140 \n Per § 156.270(f), if an enrollee is delinquent on premium payment, the QHP issuer must provide the enrollee with notice of such payment delinquency. Issuers offering QHPs in Exchanges on the Federal platform must provide such notices promptly and without undue delay, within 10-business days of the date the"},{"title":"Emergency Response Standard","type":"Proposed Rule","abstract":"OSHA is proposing through this notice of proposed rulemaking (NPRM) to issue a new safety and health standard, titled Emergency Response, to replace the existing Fire Brigades Standard. The new standard would address a broader scope of emergency responders and would include programmatic elements to protect emergency responders from a variety of occupational hazards. The agency requests comments on all aspects of the proposed rule.","document_number":"2023-28203","html_url":"https://www.federalregister.gov/documents/2024/02/05/2023-28203/emergency-response-standard","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-05/pdf/2023-28203.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-28203.pdf?1706881515","publication_date":"2024-02-05","agencies":[{"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":"Occupational Safety and Health Administration","name":"Occupational Safety and Health Administration","id":386,"url":"https://www.federalregister.gov/agencies/occupational-safety-and-health-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/386","parent_id":271,"slug":"occupational-safety-and-health-administration"}],"excerpts":"team member or responder who has successfully completed an operator training program commensurate with the type of vehicle the team member or responder will operate, or by a trainee operator who is under the supervision of a qualified operator. Operators of vehicles would have to be adequately trained, or in the process of being trained, to operate the vehicle. An untrained or inadequately trained operator poses a safety hazard to team members and responders riding in the vehicle, to operators of other vehicles, and to bystanders. \n Proposed paragraph"},{"title":"Department of Energy Acquisition Regulation (DEAR)","type":"Proposed Rule","abstract":"The Department of Energy (DOE) proposes a comprehensive revision of its Acquisition Regulation in order to update and streamline the policies, procedures, provisions and clauses that are applicable to its contracts. This rulemaking proposes to update or eliminate coverage that is obsolete or that unnecessarily duplicates the Federal Acquisition Regulation (FAR) and retain only that coverage which either implements or supplements the FAR for the award and administration of the DOE's contracts. The rule proposes the addition of several new clauses as well as amendments to several existing clauses, which will promote more uniform application of the DOE's contract award and administration policies.","document_number":"2023-16875","html_url":"https://www.federalregister.gov/documents/2023/10/26/2023-16875/department-of-energy-acquisition-regulation-dear","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-10-26/pdf/2023-16875.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-16875.pdf?1698237915","publication_date":"2023-10-26","agencies":[{"raw_name":"DEPARTMENT OF ENERGY","name":"Energy Department","id":136,"url":"https://www.federalregister.gov/agencies/energy-department","json_url":"https://www.federalregister.gov/api/v1/agencies/136","parent_id":null,"slug":"energy-department"}],"excerpts":"required to be reported to the Securities and Exchange Commission, the Federal Trade Commission, or the Department of Justice, shall also be furnished concurrently to the Contracting Officer and to the cognizant security office.\n \n (2) If a Contractor has changes involving FOCI, DOE must determine whether the changes will pose an undue risk to the common defense and security. In making this determination, DOE will consider proposals made by the Contractor to avoid or mitigate foreign influences. \n (3) If the cognizant security office at any time determines"},{"title":"Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings","type":"Proposed Rule","abstract":"OSHA is proposing to issue a new standard, titled Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings. The standard would apply to all employers conducting outdoor and indoor work in all general industry, construction, maritime, and agriculture sectors where OSHA has jurisdiction, with some exceptions. It would be a programmatic standard that would require employers to create a plan to evaluate and control heat hazards in their workplace. It would more clearly set forth employer obligations and the measures necessary to effectively protect employees from hazardous heat. OSHA requests comments on all aspects of the proposed rule.","document_number":"2024-14824","html_url":"https://www.federalregister.gov/documents/2024/08/30/2024-14824/heat-injury-and-illness-prevention-in-outdoor-and-indoor-work-settings","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-30/pdf/2024-14824.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-14824.pdf?1724935516","publication_date":"2024-08-30","agencies":[{"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":"Occupational Safety and Health Administration","name":"Occupational Safety and Health Administration","id":386,"url":"https://www.federalregister.gov/agencies/occupational-safety-and-health-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/386","parent_id":271,"slug":"occupational-safety-and-health-administration"}],"excerpts":"should specify a specific time interval at which employers must communicate with employees and, if so, what the interval should be, and the basis for such a requirement. \n X. Personal Protective Equipment (PPE) \n \n Paragraph (e)(10) of the proposed standard would require employers to maintain the cooling properties of cooling PPE if provided to employees. The proposed standard does not require employers to provide employees with cooling PPE. However, if employers do provide cooling PPE, they must ensure the PPE's cooling properties are maintained at"},{"title":"Request for Information; Essential Health Benefits","type":"Proposed Rule","abstract":"This request for information (RFI) solicits public comment on issues related to the Essential Health Benefits (EHB) under the Patient Protection and Affordable Care Act (the Affordable Care Act or ACA). CMS is issuing this RFI to gather input from the public regarding a variety of topics related to the coverage of benefits in health plans subject to the EHB requirements of the ACA. These topics include: the description of the EHB, the scope of benefits covered in typical employer plans, the review of EHB, coverage of prescription drugs, and substitution of EHB.","document_number":"2022-26282","html_url":"https://www.federalregister.gov/documents/2022/12/02/2022-26282/request-for-information-essential-health-benefits","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-12-02/pdf/2022-26282.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-26282.pdf?1669842916","publication_date":"2022-12-02","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":"the EHB Rule, for a non-grandfathered individual or small group market health plan to provide the “EHB package,” the health plan must, among other things, provide the benefits in accordance with the State's EHB-benchmark plan, as described at 45 CFR 156.115. A State's EHB-benchmark plan serves as a reference plan for the benefits considered as EHB in the State. Section 156.115(a) states that the provision of EHB means that a health plan, among other things, provides benefits that are substantially equal to the State's EHB-benchmark plan including:"}]}