Reporting Requirements for Grants to States for Rate Review Cycle IV and Effective Rate Review Program (CMS-10380)

On May 23, 2011, CMS published a final rule with comment period (76 FR 29964) to implement the annual review of unreasonable increases in premiums for health insurance coverage called for by section 2794. Under the regulation, if CMS determines that a state has an effective rate review program in a given market, using the criteria set forth in the rule, CMS will adopt that state's determinations regarding whether rate increases in that market are unreasonable, provided that the state reports its final determinations to CMS and explains the bases of its determinations. The final rule titled "Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review" (78 FR 13406, February 27, 2013) amends the standards under the rate review program. Currently, CMS relies on publicly available information and annual calls with individual States to obtain the information needed to determine whether a State has an effective rate review program. CMS is proposing to instead collect the information in writing from all States that would like to request effective status.

The latest form for Reporting Requirements for Grants to States for Rate Review Cycle IV and Effective Rate Review Program (CMS-10380) expires 2022-08-31 and can be found here.

Rate Review Program Grant - Quarterly Report

Federal Enterprise Architecture: Health - Health Care Services

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.