NONDISCRIMINATION TRAINING - SECTION 1557 AFFORDABLE CARE ACT

As a result of violations of ACA Section 1557 nondiscrimination rules, a health plan may revoke an agent or broker’s appointment with the health plan Correct: State insurance departments have jurisdiction over agent license, not HHS which is a federal entity. A health plan, however, may decide to terminate an agent or broker’s appointment with the health plans due to a violation of Section 1557 nondiscrimination rules. Under ACA Section 1557, a health plan premium sold through a state exchange may, based on an individual's age, charge higher premiums. Correct: As a general rule, Section 1557 prohibits a covered entity (such as a health plan) from excluding, denying, or limiting benefits and services based on an individual’s age. A health plan may, however, take actions based on age when it is a factor necessary to the normal operation of a program or to the achievement of a statutory objective of a program. For instance, the Affordable Care Act (ACA) permits health plans to consider age in setting premiums (within permissible ratios) and this does not violate Section 1557. The ACA restricts age ba Brainpower Read More Which Medicare programs are covered by ACA Section 1557? a.Part C (Medicare Advantage) only. b.Part D (prescription drug coverage) only. c.Parts A and B (Original Medicare) only. Parts A, C, and D, but not B. Correct: Federal financial assistance triggers Section 1557 coverage and compliance. Federal financial assistance for purposes of Section 1557 includes grants, property, Medicaid, and Medicare Parts A, C, and D payments but not Part B. HHS does not consider Medicare Part B payments to physicians to be federal financial assistance and thus Part B does not fall within the parameters of Section 1557. Federal financial assistance for purposes of Section 1557 also includes tax credits and cost-sharing sub