Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: July 18, 2016

Program Area: ACA Financial Appeals (ACA FA)

Question: An issuer has some plans with a zero (0) Cost-sharing Reduction (CSR) amount; does the Centers for Medicare & Medicaid Services (CMS) recommend the issuer to remove the rows from the Discrepancy Web Form or should the issuer include the rows since the plans were included in the 03 Policy Detail Record?

Answer: The Discrepancy Web Form includes an option where issuers are asked to indicate a 'Yes', 'No' or 'Why' if an issuer is disputing an amount associated with an entire Qualified Health Plan (QHP) or Subscriber ID. If the issuer selects yes, the issuer does not need to remove any information from the form.

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