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Submitted URL: https://www.cms.gov/cciio
Effective URL: https://www.cms.gov/marketplace/about/oversight
Submission: On October 03 via api from US — Scanned from DE
Effective URL: https://www.cms.gov/marketplace/about/oversight
Submission: On October 03 via api from US — Scanned from DE
Form analysis
2 forms found in the DOMGET /search/cms
<form region="cms_header_secondary" action="/search/cms" method="get" id="search-block-form" accept-charset="UTF-8">
<div class="js-form-item form-item js-form-type-search form-item-keys js-form-item-keys form-no-label">
<label for="edit-keys" class="ds-c-label visually-hidden">Search</label>
<label class="ds-u-visibility--screen-reader" for="header-search-input">Search</label>
<input title="Enter the terms you wish to search for." data-drupal-selector="edit-keys" class="form-autocomplete form-search ds-c-field ds-u-lg-display--none ui-autocomplete-input" data-autocomplete-path="/suggestion/autocomplete"
data-region="cms_header_secondary" data-twig-suggestion="cms_header_secondary--search-form-block" type="search" id="header-search-input" name="keys" value="" maxlength="128" placeholder="Search for keywords, topics or resources"
autocomplete="off" data-once="autocomplete placeholder">
<button class="cms-clear-button ds-u-display--none" type="button" aria-controls="header-search-input hidden-header-list-wrapper" aria-label="Clear Search Terms"><i class="fal fa-times"></i></button>
<div class="cms-popular-search-terms ds-u-display--block ds-u-lg-display--none" id="hidden-header-list-wrapper">
<span id="list-header" class="cms-list-header">Popular terms</span>
<ul aria-labelledby="list-header">
<li data-once="headerSitewideTermMatch"><span class="term">Physician Fee Schedule</span><i class="far fa-long-arrow-right" focusable="false"></i></li>
<li data-once="headerSitewideTermMatch"><span class="term">Local Coverage Determination</span><i class="far fa-long-arrow-right" focusable="false"></i></li>
<li data-once="headerSitewideTermMatch"><span class="term">Medically Unlikely Edits</span><i class="far fa-long-arrow-right" focusable="false"></i></li>
<li data-once="headerSitewideTermMatch"><span class="term">Telehealth</span><i class="far fa-long-arrow-right" focusable="false"></i></li>
<li data-once="headerSitewideTermMatch"><span class="term">Covid-19</span><i class="far fa-long-arrow-right" focusable="false"></i></li>
</ul>
</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--6zHLXczuYNA">
<div class="header-search-bar">
<input data-drupal-selector="edit-submit" data-twig-suggestion="cms_header_secondary--search-submit" type="submit" id="edit-submit--i4vgkBctTLM" value="Search" class="button js-form-submit form-submit ds-c-button ds-c-button--solid"
aria-controls="header-search-input" role="button" data-once="buttonMatch headerSitewideInitiatedMatch" aria-expanded="false">
<i class="fas fa-search" focusable="false"></i>
</div>
</div>
</form>
POST https://public.govdelivery.com/accounts/USCMS/subscribers/qualify
<form aria-label="Enter your email address for email updates" accept-charset="UTF-8" action="https://public.govdelivery.com/accounts/USCMS/subscribers/qualify" id="email-footer-form" method="post"
data-drupal-form-fields="email-footer-input,email-submit">
<div class="ds-u-display--flex" id="email-form">
<div class="ds-u-display--flex ds-u-flex-direction--column flex-grow">
<label for="email" class="ds-u-font-weight--bold ds-u-margin-bottom--1 ds-u-margin-top--3">Email</label>
<input required="required" aria-label="Enter your email address:" name="email" type="text" placeholder="you@example.com" class="ds-c-field ds-u-margin-bottom--05">
</div>
<div class="submit-button ds-u-margin-top--2">
<label id="email-submit-label" for="email-footer-submit" class="ds-u-visibility--screen-reader">Sign up - opens in a new window</label>
<button id="email-submit" aria-labelledby="email-submit-label" class="ds-c-button ds-c-button--solid cms--external-button" name="email-footer-submit" type="submit" value="Sign up" data-once="signUpMatch">Sign up</button>
</div>
</div>
</form>
Text Content
Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Centers for Medicare & Medicaid Services CMS NEWSROOM Header * About CMS * Newsroom * Data & Research SEARCH CMS.GOV Search Search Popular terms * Physician Fee Schedule * Local Coverage Determination * Medically Unlikely Edits * Telehealth * Covid-19 CMS.GOV MAIN MENU * Medicare Back to main menu MEDICARE * Enrollment & renewal Back to menu ENROLLMENT & RENEWAL * Original Medicare (Part A and B) Eligibility and Enrollment * Annual Medicare Participation Announcement * Providers & suppliers * Medicare Managed Care Eligibility and Enrollment * Part D Eligibility and Enrollment * Health plans * Coverage Back to menu COVERAGE * PrEP * Coverage Determination Process * Medicare Coverage Database * Approved facilities, trials, & registries * Telehealth * Medicare Summary Notice * Prescription drug coverage contracting * Coverage with evidence development * Investigational device exemption studies * Prescription drug coverage * Drug coverage claims data * Dental coverage * Preventive Services * Medicare Coverage Center * End Stage Renal Disease (ESRD) Center * Ambulances Services Center * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * Coding & billing Back to menu CODING & BILLING * Place of service codes * ICD-10 codes * Healthcare Common Procedure Coding System (HCPCS) * Integrated Outpatient Code Editor * National Correct Coding Initiative (NCCI) edits * NCCI for Medicaid * Electronic billing * Medicare Administrative Contractors (MACs) * Provider Customer Service Program * Skilled Nursing Facility (SNF) consolidated billing * Roster billing * Therapy services * Medicare claims & public health emergencies * Guide for Medical Technology Companies and Other Interested Parties * Payment Back to menu PAYMENT * Medicare Part B Drug Average Sales Price * All Fee-For-Service-Providers * Fee schedules * Prospective Payment Systems * Opioid Treatment Programs (OTP) * Covid-19 Vaccine Toolkit * Bankruptcy * Sustainable Growth Rates & Conversion Factors * Medicare Advantage Rates & Statistics * Medicare-Medicaid coordination Back to menu MEDICARE-MEDICAID COORDINATION * Medicare-Medicaid Coordination Office * Resources * Qualified Medicare beneficiary program * Spotlight * Events * Financial alignment initiative * Initiative to reduce avoidable hospitalizations * Reports & Guidance * Program of All-Inclusive Care for the Elderly (PACE) * Reporting Fraud * Resources for Medicare-Medicaid plans * Resources for state Medicaid agencies * Healthcare Fraud Prevention Partnership * Clinical Templates * Appeals & grievances Back to menu APPEALS & GRIEVANCES * Original Medicare appeals * Managed Care appeals & grievances * Medicare Prescription drug appeals & grievances * Ombudsman Center * Appeals Decision Search (Part C & Part D) * Quality Back to menu QUALITY * Value-based programs * Person & Family Engagement * Quality improvement organizations * Nursing home quality improvement * Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) * Home Health Quality Reporting Program * ESRD Quality Incentive Program * CMS National Quality Strategy * Hospice Quality Reporting Program * Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP) * Appropriate Use Criteria Program * Quality measures * Clinical Laboratory Improvement Amendments (CLIA) * Medicare Advantage quality improvement program * Physician compare initiative * Quality initiatives * Part C and D Performance Data * Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) * Health & safety standards Back to menu HEALTH & SAFETY STANDARDS * Quality, safety & oversight - General information * Accreditation programs * Civil monetary penalties * Quality, safety & oversight - Emergency preparedness * State survey agencies * Certification & compliance * Enforcement * Quality, safety & oversight - Guidance for laws & regulations * Promising practices project * Quality, safety & oversight - Education division (QSED) * Conditions for coverage & participation * Employers & plan sponsors Back to menu EMPLOYERS & PLAN SPONSORS * Creditable coverage * Innovation Center Back to menu INNOVATION CENTER * Overview * Audits & Compliance Back to menu AUDITS & COMPLIANCE * Part A cost report audit * Part C/Part D compliance & audits * Forms & notices Back to menu FORMS & NOTICES * CMS forms * CMS forms list * Beneficiary Notices Initiative (BNI) * Health & drug plans Back to menu HEALTH & DRUG PLANS * Plan payment * Plan payment data * Medical loss ratio * Coverage Gap Discount Program * Managed care marketing * Medicare Advantage application * Medigap (Medicare supplement health insurance) * Medical Savings Account (MSA) * Private Fee-for-Service Plans * Health Care Prepayment Plans (HCPPs) * Cost plans * Special needs plans * Network adequacy * Coordination of benefits & recovery Back to menu COORDINATION OF BENEFITS & RECOVERY * Overview * Mandatory Insurer Reporting for Group Health Plans (GHP) * Mandatory insurer reporting (NGHP) * Workers' comp Medicare set aside arrangements * Attorney services * Beneficiary services * COBA Trading Partners * Employer services * Insurer services * Prescription drug assistance programs * Provider services * Settlements Back to menu SETTLEMENTS * Jimmo Settlement * Ryan Settlement Close this menu * Medicaid/CHIP Back to main menu MEDICAID/CHIP * What is Medicaid? Back to menu WHAT IS MEDICAID? * Visit Medicaid.gov * View Medicaid maps * Visit CHIP.gov * Medicare-Medicaid Coordination Back to menu MEDICARE-MEDICAID COORDINATION * Integrated care resources * Initiative to reduce avoidable hospitalizations * Financial alignment initiative * Medicaid Integrity Institute * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * Innovation Center Back to menu INNOVATION CENTER * Overview Close this menu * Marketplace & Private Insurance Back to main menu MARKETPLACE & PRIVATE INSURANCE * About the Marketplace Back to menu ABOUT THE MARKETPLACE * Marketplace oversight * Affordable Care Act * Overview of the exchanges * Exchange coverage maps * Medicare and the Marketplace * Private Health Insurance Back to menu PRIVATE HEALTH INSURANCE * Patient’s Bill of Rights * Medical loss ratio * Annual limits * Review of insurance rates * Market rating * Self-funded, non-federal governmental plans * Grandfathered plans * Health Reimbursement Arrangements * Coverage for young adults * Student health plans * Mental health parity and addiction equity * Prevention * Consumer protections & enforcement * Pre-existing condition insurance plan * Qualifying Health Coverage (QHC) * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * CCIIO Regulations & Guidance * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * In-person assisters Back to menu IN-PERSON ASSISTERS * Information for Partners * Assister outreach & education * Applications, forms, & notices * Assister programs & procedures * Assister technical resources * Assister training & webinars * Agents & Brokers Back to menu AGENTS & BROKERS * Resources for Agent & Brokers * Registration & training * Open enrollment * Direct enrollment partners * General resources * Video Learning Center * Agent & Broker FAQ * Marketplace help desk & call centers * Registration Completion List * Marketplace Registration Tracker * AB Suspension & Termination List * Find local help * Issuer and direct enrollment partner directory * Help on demand * SHOP Resources * Health Plans & Issuers Back to menu HEALTH PLANS & ISSUERS * Qualified health plan certification * Summary of benefits & coverage * Insurance programs * Premium stabilization programs * Health insurance market reforms * Minimum essential coverage * Drug pricing & rebate review * Employers & sponsors Back to menu EMPLOYERS & SPONSORS * Coverage * Regulation & guidance * Small business tax credit & premium assistance * Appeals * Small Business Health Options Program (SHOP) * Early retiree reinsurance program * Employer initiatives * States Back to menu STATES * Planning & establishing a Marketplace * Territory cooperative agreements * Early innovator program * State flexibility to stabilize the Market * Exchange establishment grants * Pre-existing condition insurance plan * Resources Back to menu RESOURCES * About Us * Data resources * Fact sheets & FAQs * Forms, reports, & other resources * Funding opportunities * Letters * Regulations & Guidance * Training resources Close this menu * Priorities Back to main menu PRIORITIES * Innovation Center Back to menu INNOVATION CENTER * Overview * About * Key Concepts * Model Data * Value-Based Care Spotlight * Innovation Models * Where Innovation is Happening * Evaluations & Research Reports * Health Equity Back to menu HEALTH EQUITY * Coverage to Care * Minority health * Cobertura de atención * Grants & awards * Recent Legislation Back to menu RECENT LEGISLATION * Inflation Reduction Act and Medicare * No Surprises Act * Key Initiatives Back to menu KEY INITIATIVES * Opioids * Flu * Medicare Open Enrollment * Medicare OE partner resources * Marketplace Open Enrollment * E-health * Open Payments * Returning to regular operations after COVID-19 * Healthplan price transparency * Burden Reduction * About OBRHI * Stakeholder Engagement * Administrative Simplification * Interoperability * Spotlight * Contact OBRHI * Hospital price transparency * Lookup tools * Your Patient Rights Back to menu YOUR PATIENT RIGHTS * Emergency Room Rights * Medical bill rights Close this menu * Training & Education Back to main menu TRAINING & EDUCATION * CMS National Training Program Back to menu CMS NATIONAL TRAINING PROGRAM * National Training Program resources * Class modules * Partner outreach resources Back to menu PARTNER OUTREACH RESOURCES * Partner with CMS * National Medicare Education Program (NMEP) * Low-Income Subsidy (LIS) outreach * Become a champion for coverage * Respiratory Virus Vaccine Partner Toolkit * Faith-Based Partners * Rural Health Partners * American Indian/Alaska Native * Partnering with CMS Center * Medicare Learning Network (MLN) Back to menu MEDICARE LEARNING NETWORK (MLN) * Resources & training * Newsletter * Compliance * Partnerships * CMS Open Door Forums Back to menu CMS OPEN DOOR FORUMS * About Open Door Forums * Ambulance * End-Stage Renal Disease (ESRD) Dialysis Facility Care Compare * Home Health, Hospice & Durable Medical Equipment (DME) * Hospital * Long-Term Services & Supports * Physicians, Nurses and Allied Health Professionals * Rural Health * Skilled Nursing Facilities (SNFs)/Long-Term Care * Special Open Door forums * Look up topics Back to menu LOOK UP TOPICS * Medicare * Medicaid * CHIP * American Indian/Alaska Native Center * Quality of care * Special populations * Fraud & abuse * States * Privacy * Health conditions & campaigns * New Medicare Card * HIPAA Administrative Simplification * Learn More Back to menu LEARN MORE * Attend events * Find resources * Get training * Find tools to help you help others * Get digital media * Find your provider type Back to menu FIND YOUR PROVIDER TYPE * Physicians & other health professionals * Facilities * Health & drug plans * Employers & unions Close this menu * * Marketplace & Private Insurance * About the Marketplace * Marketplace oversight CONSUMER INFORMATION AND INSURANCE OVERSIGHT PAGES IN THIS SECTION * * * Marketplace oversight * * Other Insurance Protections Consumer Information and Insurance Oversight ENSURING THE AFFORDABLE CARE ACT SERVES THE AMERICAN PEOPLE The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Affordable Care Act, the historic health reform bill that was signed into law March 23, 2010. CCIIO oversees the implementation of the provisions related to private health insurance. In particular, CCIIO is working with states to establish new Health Insurance Marketplaces. CCIIO works closely with state regulators, consumers, and other stakeholders to ensure the Affordable Care Act best serves the American people. MARKETPLACE RESOURCES * Further information for partners is available on the CMS Health Insurance Marketplace website. * Consumer friendly information about new coverage options through the Health Insurance Marketplace is available at www.HealthCare.gov - Opens in a new window . * For information about employer related programs please click here. Ending Surprise Medical Bills Starting January 1, 2022, consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs are restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network. See how new rules help protect people from surprise medical bills and remove consumers from payment disputes between a provider or health care facility and their health plan, visit: cms.gov/nosurprises. Page Last Modified: 09/10/2024 06:18 PM Help with File Formats and Plug-Ins GET EMAIL UPDATES Sign up to get the latest information about your choice of CMS topics. You can decide how often to receive updates. Email Sign up - opens in a new window Sign up CMS & HHS Websites CMS & HHS Websites * Medicare.gov * Medicaid.gov * InsureKidsNow.gov * HealthCare.gov * HHS.gov * HHS.gov/Open About CMS About CMS * About Us * Careers * Newsroom * Blog Tools Tools * Acronyms * Archive * Contacts * Glossary Helpful Links Helpful Links * Privacy Policy * Plain Language * Privacy Settings Privacy Settings * Nondiscrimination & Accessibility * Developer Information * Vulnerability Disclosure Policy USA Government Sites USA Government Sites * Freedom of Information Act * No Fear Act * Inspector General * USA.gov CONNECT WITH CMS * Linkedin link * Youtube link * Facebook link * Twitter link * RSS Feed link A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244