{"abstract":"This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State's operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change.","action":"Final rule.","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/2013/08/30/2013-21338.html","cfr_references":[{"chapter":null,"citation_url":null,"part":147,"title":45},{"chapter":null,"citation_url":null,"part":153,"title":45},{"chapter":null,"citation_url":null,"part":155,"title":45},{"chapter":null,"citation_url":null,"part":156,"title":45}],"citation":"78 FR 54070","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"These regulations are effective on September 30, 2013.","disposition_notes":null,"docket_ids":["CMS-9957-F"],"dockets":[],"document_number":"2013-21338","effective_on":"2013-09-30","end_page":54146,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2013/08/30/2013-21338.xml","html_url":"https://www.federalregister.gov/documents/2013/08/30/2013-21338/patient-protection-and-affordable-care-act-program-integrity-exchange-shop-and-eligibility-appeals","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2013-21338?publication_date=2013-08-30","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2013-08-30/2013-21338/mods.xml","not_received_for_publication":null,"page_length":77,"page_views":{"count":19100,"last_updated":"2026-09-22 04:15:07 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2013-08-30/pdf/2013-21338.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2013-21338.pdf?1377720730","publication_date":"2013-08-30","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2013/08/30/2013-21338.txt","regulation_id_number_info":{"0938-AR82":{"issue":"201304","html_url":"https://www.federalregister.gov/regulations/0938-AR82/exchanges-additional-program-implementation-cms-9957-p-","title":"Exchanges: Additional Program Implementation (CMS-9957-P)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201304&RIN=0938-AR82&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AR82"],"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-2022-0008-0385","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":54070,"subtype":null,"title":"Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, and Eligibility Appeals","toc_doc":"Program Integrity; Exchange, SHOP, and Eligibility Appeals","toc_subject":"Patient Protection and Affordable Care Act:","topics":["Administrative practice and procedure","Advertising","Advisory committees","Brokers","Consumer protection","Grant programs-health","Health care","Health insurance","Health maintenance organizations (HMO)","Health records","Hospitals","Individuals with disabilities","Loan programs-health","Medicaid","Organization and functions (Government agencies)","Public assistance programs","Reporting and recordkeeping requirements","State and local governments","Sunshine Act","Technical assistance","Women","Youth"],"type":"Rule","volume":78}