CMS Turns to 'Retroactive' Tax Credits as Latest HIX Triage

For state exchanges still struggling to function, and governors facing the consequences, the Centers for Medicare & Medicaid Services is offering an exception to the rule of tax credits only being available through public marketplaces.

State exchanges that “have had difficulty in providing timely eligibility determinations to applicants and enrolling qualified individuals” now have several last-minute options to offer consumers advanced premium tax credits.

In a new bulletin from CMS’s Center for Consumer Information and Insurance Oversight, regulators wrote that insurance exchanges with such “exceptional circumstances” — including, presumably, those operated by Healthcare.gov — can make premium tax credits and cost-sharing reductions available on a retroactive basis, both for policies purchased (or in the process of being purchased) through public exchanges and those bought through private exchanges, brokers or directly from insurers.

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Source: Healthcare Payer News