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

Issue Date: January 19, 2017

Program Area: User Fees (UF)

Question: For the 2017 Benefit Year and beyond, CMS has made available the option for State-based Marketplaces using the Federal Platform (SBM-FP) to request that CMS collect the SBM-FP user fee from the State instead of directly collecting the user fee from the issuers. If an issuer in such State has qualified to receive an adjustment to the user fee for contraceptive payments set forth at 45 C.F.R. 156.50(d), how will it receive credit for the user fee adjustment?

Answer: Several states have requested the option to have CMS collect the SBM-FP user fee from the State instead of directly collecting the user fee from the issuers. For these States, as part of the SBM-FP user fee collection process, CMS will apply the contraceptive adjustment to the SBM-FP portion of the user fee amount that it invoices the State. The adjustment will only apply to the portion of the user fee owed to CMS for operation of the Federal platform, and will not affect any additional amounts that the State chooses to collect to fund its Marketplace operations. The adjustments will be equal to the sum of the monthly user fee amount that would apply to all issuers in the State, limited to the amount that each issuer owes CMS for the SBM-FP user fee each month. The contraceptive user fee adjustments will be reflected in the payment processing report with a program code labeled UFR.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.