Your Source for Health Reform

Rulemaking: ACA for lawyers

A joint effort of Illinois Health Matters and the Sargent Shriver National Center on Poverty Law to assemble the federal and Illinois final and proposed administrative rules implementing the Affordable Care Act, and to link to known compilations of related sub-regulatory guidance.

Federal rules  -  Federal sub-regulatory guidance  -  State rules and sub-regulatory guidance  -  About


 

Federal Rules

Federal ACA Rules:   2010 - 2011 - 2012 - 2013 - 2014
Federal  Sub-Regulatory Guidance

 

Methodology and usage

Rulemaking items were assembled by searching the Federal Register from 2010 to the present for "Affordable Care Act." We present items in the language used by the Federal Register in describing them, noting where proposed or interim rules have become final and where rules are still open for comment. Bookmark this page for the latest entries.

Note that we assembled the formal rulemaking for each rule into one place to assist advocates who need to get into the detailed history of the evolution of the federal rules. If you merely need to know what a final rule says, this is available and up to date at the Electronic Code of Federal Regulations.


 

Federal Sub-Regulatory Guidance

Many federal departments and agencies have a role in implementing the ACA. These agencies issue sub-regulatory guidance in a variety of ways, and make them available to the public online in a variety of ways. They do not follow any uniform format. Here are links to the ACA-related sub-regulatory guidance from the federal entities we have identified as being most heavily involved in ACA implementation. We have not tracked down sub-regulatory guidance from other issuing agencies. If you are aware of other ACA-related sub-regulatory issueances, please let us know at mstapleton@povertylaw.org, and we may add links in the future for other issuers.

US Department of Labor

US Department of Health and Human Services

Internal Revenue Service

 

Our research indicates that the following departments, agencies, offices, administrations, and commissions have issued proposed, interim, or final rules implementing the ACA:

  • Department of Health and Human Services
  • Department of Health and Human Services, Office of the Secretary
  • Department of Health and Human Services, Office of Inspector General
  • Department of Health and Human Services, Centers for Medicaid and Medicare Services
  • Department of Education
  • Department of Labor
  • Department of Labor, Employee Benefits Security Administration
  • Department of Labor, Office of Workers' Compensation Programs
  • Department of Labor, Occupational Safety and Health Administration
  • Social Security Administration
  • Department of Defense
  • Department of Defense, Office of the Secretary
  • Department of the Treasury
  • Department of the Treasury, Internal Revenue Service
  • Federal Communications Commission
  • Food and Drug Administration
  • Office of Personnel Management
  • Securities and Exchange Commission
  • Securities and Exchange Commission, Commodity Futures Trading Commission
  • Regulatory Information Service Center
  • Department of Veteran's Affairs

 

State Rules

We are working to make this section on Illinois rulemaking and Illinois subregulatory guidance as comprehensive and up-to-date as the federal rulemaking and subregulatory guidance section. But we have a long way to go. We will be adding information in the coming months. Meantime, we are including some 2013 rulemaking and partial subregulatory guidance links which suggest what we are building. Users will need to consult the Illinois Register and the Illinois Administrative Code for rulemaking and the Illinois state agency websites, such as the Department of Healthcare and Family Services, the Department of Human Services, the Department of Public Health, and the Department of Insurance for subregulatory guidance.

Jump to:   Proposed Rules  -  DOI Bulletins  -  DOI Other

 

Birth Centers

November 8, 2013: Specialized Health Care Delivery Systems. Adopted Amendments. The proposed rulemaking identifies participation requirements, record requirements, covered services and reimbursement for birth center facility services. Legislation passed in 2007 under the Alternative Healthcare Delivery Act that allowed a demonstration program for a limited number of birth centers statewide, and the Affordable Care Act affirmed birth centers as a valid place of service for delivery services. Effective Date: October 23, 2013:

89 Ill. Adm. Code 146; Illinois Register, Vol. 37, Issue 45, pg. 401-407 (17624-17630). Agency: Department of Healthcare and Family Services Download PDF


Applying for Benefits

October 18, 2013: General Administrative Provisions. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). Allows clients to have additional options for applying for benefits (telephone, online, mail, or in person); Compliance with 42 CFR 435.907 Effective Date: October 1, 2013:

89 Ill. Adm. Code 10; Illinois Register, Vol. 37, Issue 42, p. 16838-16844 (798-804). Agency: Department of Human Services Download PDF


SNAP: Applying for Benefits

October 18, 2013: Supplemental Nutrition Assistance Program (SNAP). Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). SNAP; Allows clients to have additional options for applying for benefits (telephone, online, mail, or in person); Compliance with 42 CFR 435.907 Effective Date: October 1, 2013:

89 Ill. Adm. Code 121; Illinois Register, Vol. 37, Issue 42, p. 16845-16857 (805-817). Agency: Department of Human Services Download PDF


Application Process

October 11, 2013: Application Process. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). Application for Assistance Effective Date: October 1, 2013:

89 Ill. Adm. Code 110; Illinois Register, Vol. 37, Issue 41, p. 15968-15975 (p. 203-210). Agency: Department of Healthcare and Family Services Download PDF


Newly Eligible and Former Foster Care Adults

October 11, 2013: Medical Assistance Programs. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). The rulemaking implements Article 7 of PA 98-104, which establishes eligibility for the newly eligible adults and former foster care children under the Affordable Care Act (ACA) and financial eligibility methodology mandated by the ACA for newly eligible adults and certain existing Medicaid eligible groups. Effective Date: October 1, 2013:

89 Ill. Adm. Code 120; Illinois Register, Vol. 37, Issue 41, p. 15976-15992 (p. 211-227). Agency: Department of Healthcare and Family Services Download PDF


All Kids

October 11, 2013: Covering All Kids Health Insurance Program. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). With respect to Part 123, the rulemaking implements Article 7 of PA 98-104, which establishes new financial eligibility methodology mandated by the Affordable Care Act (ACA) for children in the Covering All Kids Health Insurance Program. Effective Date: October 1, 2013:

89 Ill. Adm. Code 123; Illinois Register, Vol. 37, Issue 41, p. 15993-15996 (p. 228-231). Agency: Department of Healthcare and Family Services Download PDF


CHIP/All Kids

October 11, 2013: Children’s Health Insurance Program. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). With respect to Part 125, the rulemaking implements Article 7 of Public Act 98-104, which establishes that no application for coverage in the All Kids Rebate program shall be accepted after September 30, 2013, and establishes new financial eligibility methodology mandated by the Affordable Care Act (ACA) for the Children's Health Insurance Program. Effective Date: October 1, 2013:

89 Ill. Adm. Code 125; Illinois Register, Vol. 37, Issue 41, p. 15997-16002 (p. 232-237). Agency: Department of Healthcare and Family Services Download PDF


Medicaid: Hospital Reimbursement

October 11, 2013: Hospital Reimbursement Changes. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first). This rulemaking implements PPR policy for State fiscal year 2014 and forward. It also includes clarifications of the State fiscal year 2013 policy. Effective Date: September 27, 2013:

89 Ill. Adm. Code 152; Illinois Register, Vol. 37, Issue 41, p. 16003-16015 (p.238-250). Agency: Department of Healthcare and Family Services Download PDF


SNAP: Cost of Living Adjustment

October 11, 2013: Supplemental Nutrition Assistance Program (SNAP)
Peremptory Amendment (See note regarding peremptory rules above). This rulemaking is a result of the FY 2013 Costs of Living Adjustment to the SNAP standards and are required by Food and Nutrition Service regulations. This rulemaking increases the maximum gross and net income standards, the maximum excess shelter deduction and the standard deductions by household size for all SNAP units. This rulemaking also increases the excess shelter deduction and standard deductions. The maximum SNAP benefit amounts remain unchanged for October 2013. In addition to the above changes, this rulemaking changes the SNAP utility standard amounts. The annual review of the State's utility standards, as mandated by federal regulations, determined that an increase was warranted for the air conditioning/heating standard to $380. The results of the review require that the limited utility standard be reduced to $226, and the single utility standard be reduced to $50. The telephone standard will remain at its current amount of $28. Effective Date: October 1, 2013:

89 Ill. Adm. Code 121; Illinois Register, Vol. 37, Issue 41, p. 16016-16033 (p. 251-268). Agency: Department of Human Services Download PDF


TANF: Vehicle Asset Policy

September 20, 2013: Supplemental Nutrition Assistance Program (SNAP). Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first).. 7 CFR 273.8(f)(4) allows the use of vehicle asset policy adopted for TANF to be applied to SNAP. PA 98-114 provides that the Department of Human Services' TANF program shall disregard the value of all assets (including vehicles) held by the family, effective immediately. In accordance, vehicles will no longer be considered in determining eligibility for SNAP. Effective Date: September 9, 2013:

89 Ill. Adm. Code 121; Illinois Register, Vol. 37, Issue 38, p. 15423-15438 (p. 244-259). Agency: Department of Human Services Download PDF


TANF: Refugee Cash Assistance

September 20, 2013: Refugee/Repatriate Program. Emergency Amendment (See: Note to Reader above) (effective for 150 days or until adoption of permanent rules, whichever is first).. 45 CFR 400.66 requires that in administering a publicly-administered refugee cash assistance program, the State agency must operate its refugee cash assistance program consistent with the provisions of its TANF program in regard to the treatment of resources. PA 98-114 provides that the Department of Human Services' TANF program shall disregard the value of all assets held by the family, effective immediately. In accordance, resources will no longer be considered in determining eligibility for the Refugee Resettlement Program. Effective Date: September 9, 2013:

89 Ill. Adm. Code 115; Illinois Register, Vol. 37, Issue 38, p. 15416-15422 (237-243). Agency: Department of Human Resources Download PDF


TANF: Eligibility

September 20, 2013: Temporary Assistance for Needy Families. Emergency Amendment (effective for 150 days or until adoption of permanent rules, whichever is first).. Public Act 98-0114 amends the Temporary Assistance for Needy Families (TANF) Article of the Illinois Public Aid Code. In a provision concerning eligibility for benefits under the TANF program, this Act provides that the Department of Human Services shall disregard the value of all assets held by the family, effective immediately. As a result of this rulemaking, the value of assets shall not be considered in determining eligibility for an assistance payment. By eliminating the asset test, families can be encouraged to build a savings fund that will assist them in maintaining self-sufficiency when they experience an employment setback or other hardship. Effective Date: September 9, 2013: Citation: 89 Ill. Adm. Code 112; Illinois Register, Vol. 37, Issue 38, p. 15388-15415 (p. 209-236). Agency: Department of Human Services Download PDF


Exchanges

September 6, 2013: Health Maintenance Organization. Adopted Amendment. The federal Affordable Care Act (ACA) proposes to establish one-stop marketplaces called Exchanges. The purpose of such exchanges is to enable consumers and small businesses to choose high quality, affordable private health insurance plans that fit their health needs. The ACA specifies that beginning in 2014 insurance newly sold to individuals and small businesses through an Exchange or otherwise must be at one of four actuarial value levels: 60% (a bronze plan), 70% (a silver plan), 80% (a gold plan), and 90% (a platinum plan). These tiers do not apply to coverage already in existence meeting certain conditions (so-called "grandfathered" plans). The ACA also requires that plans cap the maximum out-of-pocket costs for enrollees, based on the out-of-pocket limits in high-deductible plans that are eligible to be paired with a Health Savings Account. Under the federal initiative, these limits are $5,950 for an individual and $11,900 for a family, and will be adjusted over time after 2014 based on increases in premiums. Previously under Part 5421, out of pocket costs were capped at $3,000 for individuals and $6,000 for families and were subject to a 50% floor for benefits. It was not possible under these rules for an HMO product to be offered at the Bronze level to individuals purchasing coverage through the Health Care Exchange because of the limitations. In order to make HMO coverage available to these individuals, the Department amended the Part to conform to the ACA cost sharing maximums so that they are consistent with the amendments to Section 4-20 of the HMO Act by P.A. 97-1148, effective January 24, 2013. In addition, housekeeping changes were made throughout the rulemaking. Effective Date: August 26, 2013:

50 Ill. Adm. Code 5421; Illinois Register, Vol. 37, Issue 36, p. 14032-14063 (p. 77-108). Agency: Department of Insurance Download PDF


Medicaid: Bed Reserve Payments

September 6, 2013: Medical Payment. Emergency Amendment (See: Note to the Reader above). The emergency-proposed amendment is authorized by PA 98-104 and allows for bed reserve payments to ICF/DDs for therapeutic visits when a resident is 21 years of age or older. Effective Date: August 20, 2013:

89 Ill. Adm. Code 140; Illinois Register, Vol. 37, Issue 36, p. 14196-14218 (p. 241-263. Agency: Department of Healthcare and Family Services Download PDF


Potentially Preventable Readmissions

August 16, 2013: Hospital Reimbursement Changes. Emergency Amendment. This rulemaking implements potentially preventable readmissions policy for State FY14 and forward. It also includes clarifications of the State fiscal year FY13 policy. Effective Date: August 1, 2013 (for maximum of 150 days)

89 Ill. Adm. Code 152; Illinois Register, Vol. 37, Issue 33, p. 13589-13602 (p. 648-659). Agency: Illinois Department of Healthcare and Family Services Download PDF


Ambulance Service Providers

August 9, 2013: Medical Payment. Adopted Amendment. This rulemaking sets forth the procedure for a Ground Ambulance Service Provider's appeal of a transportation approval decision issued by the Department or its agent. Effective Date: July 24, 2013:

89 Ill. Adm. Code 140; Illinois Register, Vol. 37, Issue 32, p. 12855-12881 (p. 242-268). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Administrative Hearings

August 9, 2013: Practice in Administrative Hearing. Adopted Amendment. Part 104 is being amended to comply with the SMART Act, PA 97-0689. Effective Date: July 24, 2013:

89 Ill. Adm. Code 104, Illinois Register, Vol. 37, Issue 32, p. 12838-12854 (p. 225-241). Agency: Department of Healthcare and Family Services Download PDF


Medicaid: Hospital Financial Assistance

August 2, 2013: Hospital Financial Assistance under the Fair Patient Billing Act. Adopted Amendment. The Hospital Financial Assistance under the Fair Patient Billing Act rules are being adopted to identify informational items that must be included in the application for financial assistance provided by Illinois hospitals to patients and to identify informational items that may not be included in the application. The rules also establish criteria for the determination of "presumptive eligibility" for financial assistance from hospitals and other criteria to be used as an alternative means for finding a patient eligible for other financial assistance programs. Effective Date: July 22, 2013:

77 Ill. Adm. Code 4500, Illinois Register, Vol. 37, Issue 31, p. 12536-12553 (p. 422-439). Agency: Department of Financial and Professional Regulation Download PDF


Community Care

July 19, 2013: Community Care Program. Emergency Amendment (See: Note to Reader above) (effective for 150 days or until adoption of permanent rule, whichever is first).. Makes correction to a typographical error in the numbering of Section 240.1615. Section 240.1530: Updates terminology by replacing references to "client" with "participant" throughout the section. Requires in-home service provider agencies to implement electronic visit verification (EVV) based on global positioning systems or other cost effective technology for monitoring the work schedules of homecare aides providing services to participants under the Community Care Program. EVV standards are posted at http://www.state.il.us/aging/1athome/awaq/EVV_Standards.pdf. Effective Date: July 1, 2013:

89 Ill. Adm. Code 240, Illinois Register, Vol. 37, Issue 29, p. 11381-11394 (p. 652-665). Agency: Department on Aging Download PDF


AIDS Drug Assistance

July 19, 2013: AIDS Drug Assistance Program. Adopted Amendment. These amendments result from the recent decision of the U.S. Department of Health and Human Services (DHHS) to suspend enrollment into pre-existing condition insurance plans (PCIP), which functioned as a bridge for those uninsured Illinoisans to obtain creditable health insurance coverage for the care of their health conditions. The AIDS Drug Assistance Program (ADAP) used the Illinois PCIP to assist those who were outside the 300% federal poverty level (FPL) threshold, not to exceed 500% (FPL), to ensure that this population had access to life sustaining medications for the treatment of HIV and AIDS. With the suspension of the Illinois-operated PCIP a unique cohort of at-risk Illinoisans will go without regular HIV pharmaceutical therapies that will sustain quality of life and in some case enhance potential life mortality. This rulemaking will secure the bridge to the population of Illinois citizens who now have no affordable access to drug coverage with the suspension of Illinois PCIP. These rules will function as a bridge to the Affordable Care Act's full implementation on January 1, 2014, when all Illinoisans will either migrate to expanded Medicaid (if legislatively approved by the assembly) or the health insurance market place. Until January 1, 2014, it is critical that the AIDS Drug Assistance Program continues to function as a safety net for a population of uninsured clients that would have had access to insurance through the Illinois PCIP until DHHS suspended this program starting March 2, 2013. A definition for the ADAP program is also being added. The rulemaking removes all language associated with Illinois Cares Rx (ICRx), which was eliminated by the State on July 1, 2012. ICRx was a state-operated pharmaceutical assistance program that ADAP coordinated to ensure that ADAP was "payer of last resort". Effective Date: July 2, 2013:

77 Ill. Adm. Code 692; Illinois Register, Vol. 37, Issue 29, p. 11371-11380 (p. 642-651). Agency: Department of Public Health Download PDF


SMART Act: Long Term Care

July 12, 2013: Long Term Care Reimbursement Changes. Adopted Amendment. These administrative rules are authorized by SMART which mandates adjustments to rates for the services provided by the long term care facilities identified in this rulemaking. Effective Date: June 27, 2013:

89 Ill. Adm. Code 153; Illinois Register, Vol. 37, Issue 28, p. 10529-10533 (p. 715-719). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Hospital Reimbursement

July 12, 2013: Hospital Reimbursement Charges. Adopted Amendment. These administrative rules are authorized by PA 97-689, also referred to as the Saving Medicaid Access and Resources Together (SMART) Act, which mandates adjustments to any rate of reimbursement for services or other payments to hospitals with certain limited exceptions. The Department is also proposing to continue to implement the potentially preventable readmission (PPR) policy as required by SMART. This policy is designed to reduce potentially preventable hospital readmissions, inpatient complications and unnecessary emergency room visits. Effective Date: June 27, 2013:

89 Ill. Adm. Code 152; Illinois Register, Vol. 37, Issue 28, p. 10517-10528 (p. 703-714). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Hospital Reimbursement

July 12, 2013: Hospital Services. Adopted Amendment. These administrative rules are authorized by SMART, which mandates adjustments to co-pays, reductions in payment for certain hospital services, and extension of certain supplemental payments to hospitals through December 31, 2014 to coincide with extension of the hospital assessment program. Effective Date: June 27, 2013:

89 Ill. Adm. Code 148; Illinois Register, Vol. 37, Issue 28, p. 10432-10516 (p. 618-702). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Fraud Prevention

July 12, 2013: Medical Programs, Medical Payment. Adopted Amendment. These amendments are to comply with the SMART Act, P.A. 97-689 and implement changes, improvements, and efficiencies to enhance Medicaid program integrity to prevent client and provider fraud. These rules also impose controls on use of Medicaid services to prevent over-use or waste; expand cost-sharing by clients; and makes rate adjustments and reductions to update rates or reflect budget realities. Effective Date: June 27, 2013:

89 Ill. Adm. Code 140; Illinois Register, Vol. 37, Issue 28, p. 10282-10431 (p. 468-617). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: FamilyCare Eligibility

July 12, 2013: Covering All Kids Health Insurance Program. Adopted Amendment. Part 125 is being amended to comply with the reduction in FamilyCare eligibility mandated by PA 97-689, the SMART Act. Effective July 1, 2012, FamilyCare eligibility is limited to individuals in families with income at or below 133 percent of the federal poverty level as established in 89 Ill. Adm. Code 120.32. The rulemaking also makes name changes to avoid inadvertent establishment of provisions, necessary to implement SMART that could be construed as conflicting with other parts of Title 89. For example, KidCare is changed to All Kids because the name KidCare is no longer used and Premium is changed to Premium Level 1 to avoid confusion with the Premium Level. In addition, this rulemaking includes changes necessary to bring the rule into compliance with recent statutory changes made in P.A. 96-1501 regarding reinstatement of benefits and P.A. 96-1272 regarding elimination of the three-month penalty period for reenrollment. Further, Part 125 is being amended to comply with the copayment requirements mandated by PA 97-689, the SMART Act. Effective Date: June 27, 2013:

89 Ill. Adm. Code 125; Illinois Register, Vol. 37, Issue 28, p. 10253-10281 (p. 439-467). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: FamilyCare Eligibility

July 12, 2013: Medical Assistance Programs. Adopted Amendment. These administrative rules are authorized pursuant to Public Act 97-689, the Save Medicaid Access and Resources Together (SMART) Act. The SMART Act terminates, as of July 1, 2012, eligibility for caretaker relatives in the Family Care Program who have income over 133% of the federal poverty level. The SMART Act also authorizes the tightening of the long term care asset testing policy for persons who seek to utilize institutional services. Effective Date: June 27, 2013:

89 Ill. Adm. Code 120; Illinois Register, Vol. 37, Issue 28, p. 10208- 10252 (p. 394-438). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Illinois Cares Rx

July 12, 2013: Illinois Cares Rx Program. Adopted Repealer. Effective July 1, 2012, Save Medicaid Access and Resources Together (SMART) Act mandates the elimination of the Illinois Cares Rx Program. Effective Date: June 27, 2013:

89 Ill. Adm. Code 119; Illinois Register, Vol. 37, Issue 28, p. 10206-10207 (p. 392-393). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: FamilyCare Eligibility

July 12, 2013: Assistance Programs, Special Eligibility Groups. Adopted Amendment. Effective July 1, 2012, the Save Medicaid Access and Resources Together (SMART) Act mandated that FamilyCare eligibility be limited to individuals in families with income at or below 133 percent of the federal poverty levels as established in 89 Ill. Adm. Code 120.32. Effective Date: June 27, 2013:

89 Ill. Adm. Code 118; Illinois Register, Vol. 37, Issue 28, p. 10201-10205 (p. 387-391). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Elimination of General Assistance

July 12, 2013: Assistance Programs, Application Process. Adopted Amendment. Public Act 97-0689, the Save Medicaid Access and Resources Together (SMART) Act, addresses the significant spending and liability deficits in the Medicaid program. SMART authorizes the elimination of the General Assistance Program. Effective Date: June 27, 2013:

89 Ill. Adm. Code 110; Illinois Register, Vol. 37, Issue 28, p. 10197- 10200 (p. 383-386). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Administrative Hearings

July 12, 2013: Practice in Administrative Hearings. Adopted Amendment. Part 104 is being amended to comply with the SMART Act, PA 97-689. Involves amendments to: Assistance Appeals, Responsible Relative and Joint Payee Petitions, Medical Vendor and Alternative Payee Hearings, Rules for Joint Department Actions Against Skilled Nursing Facilities and Intermediate Care Facilities Participating in the Medicaid Program, Food Stamp Administrative Disqualification Hearings, Incorporation by Reference, Unauthorized Use of Medical Assistance Effective Date: June 27, 2013:

89 Ill. Adm. Code 104; Illinois Register, Vol. 37, Issue 28, p. 10172-10196 (p. 258-382). Agency: Department of Healthcare and Family Services Download PDF


SMART Act: Social Services

July 12, 2013: Social Services, General Provisions. Adopted Amendment. Part 101 is being amended to comply with the SMART Act, PA 97-0689. Effective Date: June 27, 2013:

89 Ill. Adm. Code 101; Illinois Register, Vol. 37, Issue 28, p. 10152-10171 (p. 338-357). Agency: Department of Healthcare and Family Services Download PDF


 

Illinois Proposed Amendments, Rules, and Repeals with Comments Due

ACA implementation, HFS to DHS moves

Issued: November 8, 2013: Proposed Amendment Issued by Department of Healthcare and Family Services: Amendment to make changes necessary to implement ACA, and streamline existing language that removes references to programs that are no longer implemented by HFS, but now by DHS. Comments were due: December 23, 2013.

89 Ill. Adm. Code 102. Illinois Register, Vol. 37, Issue 45, pg. 26-35 (17249-17258)
Download PDF


Newly eligible and former foster care adults

Issued: November 8, 2013: Proposed Amendment Issued by Department of Healthcare and Family Services: Rulemaking regarding eligibility for newly eligible adults and former foster care and financial eligibility methodology mandated by the ACA for newly eligible adults and certain existing Medicaid eligible groups. Comments were due: December 23, 2013.

89 Ill. Adm. Code 120. Illinois Register, Vol. 37, Issue 45, pg. 49-69 (17272-17292)
Issued: November 8, 2013: Download PDF


All Kids

Issued: November 8, 2013: Proposed Amendment Issued by Department of Healthcare and Family Services: Rulemaking regarding new financial eligibility methodology mandated by hthe ACA for children in the Covering All Kids Health Insurance Program. Cleans up co-ayments and cost sharing provisions by eliminating references to coverage that nolonger exists in the Covering All Kids Health Insurance program. Comments were due: December 23, 2013.

89 Ill. Adm. Code 123. Illinois Register, Vol. 37, Issue 45, pg. 70-86 (17293-17309)
Download PDF


All Kids

Issued: November 8, 2013: Proposed Amendment Issued by Department of Healthcare and Family Services: Rulemaking to implement law that establishes that no application for coverage in the All Kids Rebate program shall be accepted after September 30, 2013, and establishes new financial eligibility methodology manded by the ACA for hte Children’s Health Insurance Program. Comments were due: December 23, 2013.

89 Ill. Adm. Code 125. Illinois Register, Vol. 37, Issue 45, pg. 87-107 (17310-17330)
Download PDF


SNAP, ACA enrollment

Issued: October 18, 2013: Proposed Amendment Issued by Department of Human Services: SNAP; Streamlining of Procedures for Enrollment Through an Exchange and State Medicaid, CHIP and Health Subsidy Programs; Compliance with 42 CFR 435.907 which requires states to provide an application form which can be filed online, in person, by mail, or telephone. Gives clients additional option for applying for benefits. Comments were due: December 2, 2013.

89 Ill. Adm. Code 121. Illinois Register, Vol. 37, Issue 42, pg. 262-263 (16302-16303) Download PDF


ACA enrollment

Issued: October 18, 2013: Proposed Amendment Issued by Department of Human Services: Streamlining of Procedures for Enrollment Through an Exchange and State Medicaid, CHIP and Health Subsidy Programs; Compliance with 42 CFR 435.907 which requires states to provide an application form which can be filed online, in person, by mail, or telephone. Gives clients additional option for applying for benefits. Comments were due: December 2, 2013.
89 Ill. Adm. Code 10. Illinois Register, Vol. 37, Issue 42, pg. 260-261 (16300-16301) Download PDF


 

Illinois Department of Insurance Bulletins

July 22, 2013: Filing of Plans to be Sold Off of the Illinois Health Marketplace - CB 2013-12 Download PDF NOTE: The above was revised on August 19, 201

June 20, 2013: Reaffirmation of the department's position on premium adjustments after audit pursuant to 215 ILCS 5/143.17a - CB 2013-09 Download PDF

May 31, 2013: Supplemental Guideline for Filing Stand-Alone Dental Plans - CB 2013-08 Download PDF

April 29, 2013: Manipulation of Plan Year for Non-Grandfathered Individual & Group Health Benefit Plans - CB 2013-07 Download PDF

March 29, 2013: Illinois Qualified Health Plan Application Guidelines - CB 2013-06 Download PDF

March 20, 2013: Qualified Health Plan Fees - CB 2013-04 Download PDF

March 20, 2013: Draft of Illinois Qualified Health Plan Application Guidelines CB 0213-03 Download PDF

January 24, 2013: Dental Minimum Reimbursement Level - CB 2013-02 Download PDF

December 19, 2012: Financial Reporting of ACA Rebates per SSAP 66 - CB 2012-10 Download PDF

December 6, 2012: Comments concerning: Financial Reporting, Health Insurance Reporting, & Policy Form Filings - CB 2012-07 Download PDF

August 30, 2012: Preventive Health Care for Women - CB 2012-05 Download PDF

December 13, 2010: Standard Health Applications - CB 2010-10 Download PDF

December 7, 2010: Notice of Protection By Illinois Life and Health Guaranty Association - 50 IAC 3401 - CB 2010-07 Download PDF

November 9, 2010: Required Submission and Approval of Actuarial Memorandum and Justification Review Standards for New and Renewal Health Rates - CB 2010-08 Download PDF

August 9, 2010: Directions for Certified PPACA Compliance Filings -UPDATED - CB 2010-04A Download PDF NOTE: This replaced CB 2010-03

May 27, 2010: The Health Carrier External Review Act
Industry Advisory Bulletin; Registration of External Independent Review Download PDF

May 14, 2010: Department Notice of Intent to Expedite Review of Certified PPACA Compliance Filings - CB 2010-02 Download PDF


 

Illinois Department of Insurance - Other Documents

September 30, 2013: Illinois Qualified Health Plans; Summary of Filed Plans Download PDF

September 30, 2013: Illinois Qualified Health Plans Rate Levels Download PDF

September 23, 2013: Health Insurance Marketplace Precautions: Illinois Department of Insurances cautions citizens to take necessary precautions to guard against fraud/misconduct when considering enrollment in the health insurance marketplace. Download PDF

Illinois Health Insurance Reform http://www2.illinois.gov/gov/healthcarereform/Pages/TheAffordableCareAct.aspx

Dental Plans/Rates https://www.healthcare.gov/dental-plan-information/

Health Plans/Rates https://www.healthcare.gov/health-plan-information/

SHOP Dental Plans/Rates https://www.healthcare.gov/shop-dental-plan-information/

SHOP Health Plans/Rates https://www.healthcare.gov/shop-health-plan-information/


 

The ACA for Lawyers page is a joint production of Illinois Health Matters and the Sargent Shriver National Center on Poverty Law. We join in giving a round of applause to two volunteers – Jamie Feldman, Illinois attorney and 2013 graduate of the Indiana University Maurer School of Law and Jessica Jackson-McLain, JD ’14, Indiana University Maurer School of Law – for their hard and smart work in assembling these materials.

If you have questions or comments regarding this material, please contact us at mstapleton@povertylaw.org.