{"abstract":"This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.","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/2016/03/08/2016-04439.html","cfr_references":[{"chapter":null,"citation_url":null,"part":144,"title":45},{"chapter":null,"citation_url":null,"part":147,"title":45},{"chapter":null,"citation_url":null,"part":153,"title":45},{"chapter":null,"citation_url":null,"part":154,"title":45},{"chapter":null,"citation_url":null,"part":155,"title":45},{"chapter":null,"citation_url":null,"part":156,"title":45},{"chapter":null,"citation_url":null,"part":158,"title":45}],"citation":"81 FR 12204","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"These regulations are effective on May 9, 2016.","disposition_notes":null,"docket_ids":["CMS-9937-F"],"dockets":[],"document_number":"2016-04439","effective_on":"2016-05-09","end_page":12352,"executive_order_notes":null,"executive_order_number":null,"explanation":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2016/03/08/2016-04439.xml","html_url":"https://www.federalregister.gov/documents/2016/03/08/2016-04439/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2017","images":{"ER08MR16.000":{"large":"https://img.federalregister.gov/ER08MR16.000/ER08MR16.000_large.png","original_size":"https://img.federalregister.gov/ER08MR16.000/ER08MR16.000_original_size.png"}},"images_metadata":{"ER08MR16.000":{"large":{"identifier":"ER08MR16.000","content_type":"image/png","size":6429,"width":745,"sha":"14b1254bd7af086bc26bfc8d93fb884d","url":"https://img.federalregister.gov/ER08MR16.000/ER08MR16.000_large.png","height":61},"original_size":{"identifier":"ER08MR16.000","content_type":"image/png","size":8109,"width":2676,"sha":"f0a14601d5d20618ddfbddcd32189e86","url":"https://img.federalregister.gov/ER08MR16.000/ER08MR16.000_original_size.png","height":219}}},"json_url":"https://www.federalregister.gov/api/v1/documents/2016-04439?publication_date=2016-03-08","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2016-03-08/2016-04439/mods.xml","not_received_for_publication":null,"page_length":149,"page_views":{"count":46266,"last_updated":"2026-04-17 22:15:06 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2016-03-08/pdf/2016-04439.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2016-04439.pdf?1456780524","publication_date":"2016-03-08","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2016/03/08/2016-04439.txt","regulation_id_number_info":{"0938-AS57":{"issue":"201510","html_url":"https://www.federalregister.gov/regulations/0938-AS57/cy-2017-notice-of-benefit-and-payment-parameters-cms-9937-p-","title":"CY 2017 Notice of Benefit and Payment Parameters (CMS-9937-P)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201510&RIN=0938-AS57&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AS57"],"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-2022-0008-0470","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":12204,"subtype":null,"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017","toc_doc":"Benefit and Payment Parameters","toc_subject":"Patient Protection and Affordable Care Act:","topics":["Administrative practice and procedure","Advertising","Claims","Consumer protection","Grant programs-health","Grants administration","Health care","Health insurance","Health maintenance organizations (HMO)","Health records","Hospitals","Individuals with disabilities","Loan programs-health","Medicaid","Organization and functions (Government agencies)","Penalties","Public assistance programs","Reporting and recordkeeping requirements","State and local governments","Sunshine Act","Technical assistance","Women","Youth"],"type":"Rule","volume":81}