[Federal Register Volume 78, Number 215 (Wednesday, November 6, 2013)]
[Rules and Regulations]
[Pages 66653-66655]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-26579]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

45 CFR Parts 153, 155, 156, 157, and 158

[CMS-9964-F3]
RIN-0938-AR51


Patient Protection and Affordable Care Act; HHS Notice of Benefit 
and Payment Parameters for 2014; Correcting Amendment

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Correcting amendment.

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SUMMARY: In the March 11, 2013 issue of the Federal Register, we 
published a

[[Page 66654]]

final rule entitled, ``Patient Protection and Affordable Care Act; HHS 
Notice of Benefit and Payment Parameters for 2014''. This correcting 
amendment corrects several technical and typographical errors 
identified in the March 11, 2013 final rule.

DATES: This correcting amendment is effective November 6, 2013.

FOR FURTHER INFORMATION CONTACT:

Jeff Wu, (301) 492-4305.
Adrianne Glasgow, (410) 786-0686.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2013-04902 (78 FR 15410), the final rule entitled, 
``Patient Protection and Affordable Care Act; HHS Notice of Benefit and 
Payment Parameters for 2014'' there were technical and typographical 
errors that are identified and corrected in the regulations text of 
this correcting amendment. The effective date of the final rule was 
April 30, 2013.

A. Summary of Errors in the Preamble

    On page 15421, in our discussion of factors included in the HHS 
risk adjustment models, we inadvertently omitted language regarding how 
an enrollee's age for risk score calculation will be determined.
    On page 15493, in our discussion of limiting the definition of cost 
sharing to Essential Health Benefits, we inadvertently included the 
incorrect section reference to the Affordable Care Act.
    On page 15495, in our discussion of estimating the value of cost-
sharing reductions to be provided under the limited cost sharing plan 
variation open to Indians regardless of household income, we made 
typographical errors.
    On pages 15503 and 15504 in our discussion regarding determining 
employer size for purposes of participation in the Small Business 
Health Option Program, we made inadvertent minor errors. On page 15505, 
in our discussion of the medical loss ratio formula, a phrase was 
erroneously included.
    On page 15506, in our discussion of the technical correction to 
Sec.  158.232(d), we made an inadvertent technical error.

B. Summary of Errors in the Regulations Text

    On page 15526, in the regulation text of--
     Section153.220(c)(2), we inadvertently used the term 
``if'' instead of the term ``of;'' and
     Section 153.230(a), we inadvertently omitted the term 
``collected'' after the phrase ``for reinsurance payments from 
contributions.''
    On page 15529, in the regulations text of Sec.  153.405(b), we 
inadvertently omitted references to paragraphs (f) and (g) of this 
section.
    On page 15540, in the regulation text of Sec.  158.232(d), we 
inadvertently used the term ``and'' instead of the term ``an.''

II. Correction of Errors in the Preamble

    1. On page 15421, first column, second full paragraph, lines 4 
through 10, the sentence ``To align with model calibration, an 
enrollee's age for risk score calculation will be the age as of the 
enrollee's last day of enrollment in a risk adjustment covered plan in 
the applicable benefit year will be used for enrollees in program 
operation.'' is corrected to read ``To align with model calibration, an 
enrollee's age for risk score calculation for all enrollment periods 
will be based on the enrollee's age in years on the last date of 
enrollment in the applicable benefit year in any risk adjustment 
covered plan for the issuer''.
    2. On page 15493, third column, fourth full paragraph, line 2, 
``section 1301(c)'' is corrected to read ``section 1302(c)(3).''
    3. On page 15495, third column, first full paragraph, lines 1 
through 15, the sentences ``We are finalizing both our proposal for 
annual rulemaking in the notice of benefits and payment provisions to 
establish a methodology for advance payments for cost-sharing 
reductions under the limited cost sharing plan variation, and our 
proposal of a specific methodology for the 2014 benefit year. As in the 
case of the other plan variation, we plan to review the methodology for 
calculating the advance payments once more data is available, and 
future notices of benefits and payment parameters may include different 
methodologies.'' is corrected to read ``We are finalizing both our 
proposal for annual rulemaking in the HHS notice of benefit and payment 
parameters provisions to establish a methodology for advance payments 
for cost-sharing reductions under the limited cost sharing plan 
variation, and our proposal of a specific methodology for the 2014 
benefit year. As in the case of the other plan variations, we plan to 
review the methodology for calculating the advance payments once more 
data is available, and future HHS notices of benefit and payment 
parameters may include different methodologies.''
    4. On page 15503, third column,
    a. Second full paragraph, line 10 ``IRC'' is corrected to read 
``Code.''
    b. Third full paragraph,
    (1) Line 6, ``IRC'' is corrected to read ``Code.''
    (2) Line 8, ``IRC'' is corrected to read ``Code.''.
    5. On page 15504, first column,
    a. First full paragraph, line 3, ``this Notice'' is corrected to 
read ``this final rule''.
    b. Second full paragraph, line 3, ``IRC'' is corrected to read 
``Code''.
    6. On page 15505, second column, last paragraph, lines 1 through 4, 
the sentence ``Issuers must provide rebates to enrollees if their MLRs 
fall short of the applicable MLR standard for the reporting year.'' is 
corrected to read ``Issuers must provide rebates if their MLRs fall 
short of the applicable MLR standard for the reporting year.''.
    7. On page 15506, third column, last paragraph, line 9, the phrase 
``50 percent--n'' is corrected to read ``50 percent [supcaret] n''.
    8. On page 15540, second column, second paragraph, line 3, the 
sentence ``Beginning with the 2013 MLR reporting year, the credibility 
adjustment for and MLR based on partially credible experience is zero 
if both of the following conditions are met:'' is corrected to read 
``Beginning with the 2013 MLR reporting year, the credibility 
adjustment for an MLR based on partially credible experience is zero if 
both of the following conditions are met:''

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary finds, for 
good cause, that the notice and comment process is impracticable, 
unnecessary, or contrary to the public interest, and incorporates a 
statement of the finding and the reasons therefore in the notice.
    Section 553(d) of the APA ordinarily requires a 30-day delay in 
effective date of final rules after the date of their publication in 
the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds there is good cause to do so, and 
the agency incorporates a statement of the findings and its reasons in 
the rule issued.
    This document merely corrects technical and typographic errors in 
the Patient Protection and Affordable Care Act; HHS Notice of Benefit 
and Payment Parameters for 2014 final rule that was

[[Page 66655]]

published on March 11, 2013 and became effective on April 30, 2013. The 
changes are not substantive changes to the standards set forth in the 
final rule. Therefore, we believe that undertaking further notice and 
comment procedures to incorporate these corrections and delay the 
effective date for these changes is unnecessary. In addition, we 
believe it is important for the public to have the correct information 
as soon as possible, and believe it is contrary to the public interest 
to delay when they become effective. For the reasons stated previously, 
we find there is good cause to waive notice and comment procedures and 
the 30-day delay in the effective date for this correction notice.

List of Subjects

45 CFR Part 153

    Administrative practice and procedure, Adverse selection, Health 
care, Health insurance, Health records, Organization and functions 
(Government agencies), Premium stabilization, Reporting and 
recordkeeping requirements, Reinsurance, Risk adjustment, Risk 
corridors, Risk mitigation, State and local governments.

45 CFR Part 158

    Administrative practice and procedure, Claims, Health care, Health 
insurance, Health plans, penalties, Reporting and recordkeeping 
requirements, Premium revenues, Medical loss ratio, Rebating.

    As noted in section I of this correcting amendment, the Department 
of Health and Human Services is making the following correcting 
amendments to 45 CFR parts 153 and 158.

PART 153--STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND 
RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT

0
1. The authority citation continues to read as follows:

    Authority:  Secs. 1311, 1321, 1341-1343, Pub. L. 111-148, 24 
Stat. 119.


Sec.  153.220  [Amended]

0
2. In Sec.  153.220(c)(2), the phrase ``if this section'' is removed 
and the phrase ``of this section'' is added in its place.


Sec.  153.230  [Amended]

0
3. In Sec.  153.230(a), the phrase ``for reinsurance payments from 
contributions'' is removed and the phrase ``for reinsurance payments 
from contributions collected'' is added in its place.


Sec.  153.405  [Amended]

0
4. In Sec.  153.405(b), the phrase ``(d) or (e) of this section'' is 
removed and the phrase ``(d) through (g) of this section'' is added in 
its place.

PART 158--ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE 
REQUIREMENTS

0
5. The authority citation for part 158 continues to read as follows:

    Authority: Section 2718 of the Public Health Service Act (42 
U.S.C. 300gg-18, as amended).


Sec.  158.232  [Amended]

0
6. In Sec.  158.232(d) introductory text, the phrase ``adjustment for 
and'' is removed and the phrase ``adjustment for an'' is added in its 
place.

    Dated: October 30, 2013.
Jennifer M. Cannistra,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2013-26579 Filed 11-5-13; 8:45 am]
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