{"abstract":"This interim final rule with comment period sets the payment rates for covered services furnished to individuals enrolled in the Pre-Existing Condition Insurance Plan (PCIP) program administered directly by HHS beginning with covered services furnished on June 15, 2013. This interim final rule also prohibits facilities and providers who, with respect to dates of service beginning on June 15, 2013, accept payment for most covered services furnished to an enrollee in the federally-administered PCIP from charging the enrollee an amount greater than the enrollee's out-of-pocket cost for the covered service as calculated by the plan. The PCIP program was established under Section 1101 of Title I of the Patient Protection and Affordable Care Act (Affordable Care Act).","action":"Interim final rule with comment period.","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"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2013/05/22/2013-12145.html","cfr_references":[{"chapter":null,"citation_url":null,"part":152,"title":45}],"citation":"78 FR 30218","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective date: This interim final regulation is effective on June 15, 2013.","disposition_notes":null,"docket_ids":["CMS-9995-IFC3"],"dockets":[],"document_number":"2013-12145","effective_on":"2013-06-15","end_page":30226,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2013/05/22/2013-12145.xml","html_url":"https://www.federalregister.gov/documents/2013/05/22/2013-12145/pre-existing-condition-insurance-plan-program","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2013-12145?publication_date=2013-05-22","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2013-05-22/2013-12145/mods.xml","not_received_for_publication":null,"page_length":9,"page_views":{"count":3591,"last_updated":"2026-06-20 20:15:03 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2013-05-22/pdf/2013-12145.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2013-12145.pdf?1368821832","publication_date":"2013-05-22","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2013/05/22/2013-12145.txt","regulation_id_number_info":{"0938-AQ70":{"issue":"201104","html_url":"https://www.federalregister.gov/regulations/0938-AQ70/pre-existing-condition-insurance-plan-cms-9995-f-","title":"Pre-Existing Condition Insurance Plan (CMS-9995-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201104&RIN=0938-AQ70&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AQ70"],"regulations_dot_gov_info":{"supporting_documents":[],"comments_count":0,"agency_id":"HHS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=HHS-OS-2022-0008","supporting_documents_count":0,"docket_id":"HHS-OS-2022-0008","document_id":"HHS-OS-2022-0008-0370","regulation_id_number":null,"title":"HHS 2022 Archive","checked_regulationsdotgov_at":"2022-05-28T03:30:05Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":30218,"subtype":null,"title":"Pre-Existing Condition Insurance Plan Program","toc_doc":"Pre-Existing Condition Insurance Plan Program","toc_subject":null,"topics":["Administrative practice and procedure","Health care","Health insurance","Penalties","Reporting and recordkeeping requirements"],"type":"Rule","volume":78}