Data / Federal rules / 2026-10050
Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program
The Centers for Medicare & Medicaid Services published this final rule in the Federal Register on May 20, 2026. It took effect on July 20, 2026.
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What the agency says
This final rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); requirements related to defrayal for the cost of any State-required benefits in addition to the EHB; cost- sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive plan years; QHP issuer quality improvement strategies (QISs); and revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States. This final rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.
Key facts
- Document number
- 2026-10050
- Type
- Final rule
- Action
- Final rule
- Agency
- Health and Human Services Department; Centers for Medicare & Medicaid Services
- Published
- May 20, 2026
- Takes effect
- July 20, 2026
- Dates
- These regulations are effective on July 20, 2026.
- Docket
- CMS-9883-F
- Regulation ID (RIN)
- 0938-AV62
- Code of Federal Regulations
- 42 CFR 600; 45 CFR 150; 45 CFR 155; 45 CFR 156
- Topics
- Administrative practice and procedure; Advertising; Advisory committees; Brokers; Consumer protection; Grant programs-health; Health care; Health insurance; Health maintenance organizations (HMO); Health records; Hospitals; Indians; Individuals with disabilities; Intergovernmental relations; 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
- Significant
- Yes, under Executive Order 12866
- Pages
- 352
Other documents from the Centers for Medicare & Medicaid Services
Everything from the Centers for Medicare & Medicaid Services · Rules on administrative practice and procedure · Rules on advertising · Rules on advisory committees · Published in May 2026
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.