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

Issue Date: July 18, 2016

Program Area: ACA Financial Appeals (ACA FA)

Question: Can the Centers for Medicare & Medicaid Services (CMS) clarify the difference between the Discrepancy Web Form and the Discrepancy Resolution inbound specifications process for reporting invalid Qualified Health Plan (QHP) IDs for the Cost-sharing Reduction (CSR) Reconciliation?

Answer: Issuers should use the Discrepancy Web Form to dispute any discrepancy found during the CSR Reconciliation process. The Discrepancy Resolution inbound specifications process is used if CMS made a discrepancy determination that an issuer would like to appeal further.

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