2019- TSGAC Letter: Re-Review of Summary of Benefits and Coverage Documents

In 2019, TSGAC recommended that the CMS Tribal Technical Advisory Group urge CMS to consider the following:

1. Individual health plan issuers identified in the report be contacted by CCIIO, informed of the deficiencies in their SBCs, and educated on the need to act rapidly to correct these deficiencies; and

2. Given the amount of time that certain health plan issuers have posted inaccurate descriptions of the Indian-specific cost-sharing protections in their SBCs, it is warranted that CCIIO conduct a review of the operations of these issuers to determine if they have applied the L-CSVs correctly and completely and if they have not, require these issuers to make whole individual American Indian and Alaska Native enrollees for any erroneous cost-sharing expenditures made.

File Type: pdf
Categories: Advisory Committee Correspondence