Vendor Management, Payments, and Collections (VMPC) FAQ
Guidance for FAQ regarding Payment Processing and General Information
Program Area: Vendor Management, Payments, and Collections (VMPC)
Question: Is the cost-sharing reduction (CSR) amount represented on the 834 enrollment transaction the amount the Centers for Medicare & Medicaid Services (CMS) will pay for enrollees in CSR-eligible plans?
Answer: The 834 enrollment transaction that the Marketplace transmits to issuers and CMS will include the advance CSR payment amount that the issuer can expect to receive from CMS each month on behalf of the enrollment group. This amount represents the advance CSR payment, not actual CSRs paid on behalf of eligible enrollees throughout the benefit year. Please see 156.430 of the HHS Notice of Benefit and Payment Parameters for 2015; Final Rule published March 11, 2014.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 24, 2013
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