Regulations

Welcome to Covered California’s Regulations page. This page contains links to statutes and regulations relevant to Covered California. The linked documents below are in Portable Document Format (PDF). Adobe Acrobat Reader is required to view and print these documents

Federal Comment Letters

Covered California periodically submits comments to the federal government on emerging federal policy and rulemaking activities that impact Covered California. This page provides links to Covered California federal comment letters submitted since 2010.

2026

Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program – Proposed Rule (RIN 0938-AV63) — Centers for Medicare & Medicaid Services (CMS) — January 26, 2026

2025

2024

Draft Data Exchange Framework (DxF) Roadmap – Request for Comment – CalHHS Center for Data Insights and Innovation (CDII) – December 6, 2024
Enhancing Coverage of Preventive Services Under the Affordable Care Act – Proposed Rule (RINs 1545-BR35; 1210-AC25; 0938-AV57) – Centers for Medicare & Medicaid Services (CMS), Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS) – December 20, 2024
Notice of Request for Public Comments on Draft Recommendations for the HRSA-Supported Women's Preventive Services Guidelines Relating to Screening and Counseling for Intimate Partner and Domestic Violence, Breast Cancer Screening for Women at Average Risk, and Patient Navigation for Breast and Cervical Cancer Screening – Notice – Health Resources and Services Administration (HRSA) – November 21, 2024

Patient Protection and Affordable Care Act: Notice of Benefit and Payment Parameters for 2026 and Basic Health Program – Proposed Rule (RIN#0938-AV41) – Centers for Medicare & Medicaid Services (CMS) – November 12, 2024
Medicare and Medicaid Programs; 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments – Proposed Rule (RIN 0938-AV33) Joint Comments with CalPERS – Centers for Medicare & Medicaid Services – September 9, 2024
Pay PCPs Act of 2024 Joint Comments with CalPERS – Request for Information – Senators Cassidy and Whitehouse – July 15, 2024
2024 Measure Set Review Measures for Public Comment – Partnership for Quality Measurement – May 31, 2024
Centers for Medicare & Medicaid Services Draft 2024 Call Letter for the Quality Rating System (QRS) and Qualified Health Plan (QHP) Enrollee Experience Survey – Centers for Medicare & Medicaid Services – March 26 2024
Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2025; Updating Section 1332 Waiver Public Notice Procedures; Medicaid; Consumer Operated and Oriented Plan (CO-OP) Program; and Basic Health Program – Proposed Rule (RIN#0938-AV22) – Centers for Medicare & Medicaid Services (CMS) – January 8 2024

2023

2022

2021

Public Consultation on the Draft HHS Strategic Plan FY 2022 – 2026 – Request for Comments – U.S. Department of Health and Human Services (HHS) – November 5, 2021
Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Proposed Rule (CMS-9906-P) – Proposed Rule (RIN# 0938-AU18 1505-AC72) – Centers for Medicare & Medicaid Services (CMS), Internal Revenue Service (IRS) – July 28, 2021
Public Charge Ground of Inadmissibility – Advance Notice of Proposed Rulemaking (RIN# 1615-AC74) – U.S. Citizenship and Immigration Services (USCIS) – October 22, 2021

2020

Draft 2021 Actuarial Value Calculator Methodology– Guidance – Centers for Medicare & Medicaid Services (CMS) – January 21, 2020
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans (CMS-9916-P)– Proposed Rule (RIN# 0938-AT98) – Centers for Medicare & Medicaid Services (CMS) – March 1, 2020
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans (CMS-9916-P)– Proposed Rule (RIN# 0938-AT98) – Centers for Medicare & Medicaid Services (CMS) – March 1, 2020
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards; Updates to State Innovation Waiver (Section 1332 Waiver) Implementing Regulations; (CMS-9914-P)– Proposed Rule (RIN# 0938-AU18) – Centers for Medicare & Medicaid Services (CMS), Internal Revenue Service (IRS) – December 30, 2020

2019

Patient Protection and Affordable Care Act; Exchange Program Integrity (CMS-9922-P)– Proposed Rule (RIN# 0938-AT53) – Centers for Medicare & Medicaid Services (CMS) – January 8, 2019
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020 (CMS-9926-P)– Proposed Rule (RIN# 0938-AT37) – Centers for Medicare & Medicaid Services (CMS) – February 19, 2019
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020 (CMS-9926-P)– Proposed Rule (RIN# 0938-AT37) – Centers for Medicare & Medicaid Services (CMS) – February 19, 2019
Patient Protection and Affordable Care Act: Increasing Consumer Choice through the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts (CMS-9921-NC)– Request for Information (RIN# 0938-ZB45) – Centers for Medicare & Medicaid Services (CMS) – May 6, 2019
Consumer Inflation Measures Produced by Federal Statistical Agencies– Request for Comments – Office of Management and Budget (OMB). – June 21, 2019
Nondiscrimination in Health and Health Education Programs or Activities– Proposed Rule (RIN# 0945-AA11) – Centers for Medicare and Medicaid; Office for Civil Rights (OCR) – August 13, 2019
Agency Information Collection Activities; Proposals, Submissions, and Approvals: Immigrant Health Insurance Coverage– Request for Comments – U.S. Department of State – October 30, 2019
Brief of Amici Curiae signed by California Attorney General re Doe v. Trump– Litigation – United States District Court – November 12, 2019

2018

Short-Term, Limited-Duration Insurance (CMS-9924-P)– Proposed Rule (RIN#s 0938-AT48; 1210-AB86; 1545-BO41) – Centers for Medicare & Medicaid Services (CMS), Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS) – April 23, 2018
Health Reimbursement Arrangements and Other Account-Based Group Health Plans (CMS-9918-P)– Proposed Rule (RIN#s 0938-AT90; 1210-AB87; 1545-BO46) – Centers for Medicare & Medicaid Services (CMS), Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS) – December 28, 2018

2017

Patient Protection and Affordable Care Act; Market Stabilization (CMS-9929-P)– Proposed Rule (RIN# 0938-AT14) – Centers for Medicare & Medicaid Services (CMS) – March 6, 2017
Patient Protection and Affordable Care Act; Market Stabilization (CMS-9929-P)– Proposed Rule (RIN# 0938-AT14) – Centers for Medicare & Medicaid Services (CMS) – March 6, 2017
Patient Protection and Affordable Care Act: Reducing Regulatory Burdens & Improving Health Care Choices to Empower Patients (CMS-9928-NC)– Request for Information (RIN# 0938-ZB39) – Centers for Medicare & Medicaid Services (CMS) – July 12, 2017
Request for Information on Centers for Medicare & Medicaid Services: Innovation Center New Direction– Request for Information – Centers for Medicare & Medicaid Services (CMS) – November 20, 2017
Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019 (CMS-9930-P)– Proposed Rule (RIN# 0938-AT12) – Centers for Medicare & Medicaid Services (CMS) – November 27, 2017

2016

Draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces– Guidance – Centers for Medicare & Medicaid Services (CMS) – January 15, 2016
Patient Protection and Affordable Care Act: Benefit and Payment Parameters for 2018 (CMS-9934-P)– Proposed Rule (RIN# 0938-AS95) – Centers for Medicare & Medicaid Services (CMS) – October 6, 2016

2015

Patient Protection and Affordable Care Act: Benefit and Payment Parameters for 2017 (CMS-9937-P)– Proposed Rule (RIN# 0938-AS57) – Centers for Medicare & Medicaid Services (CMS) – December 21, 2015

2014

Patient Protection and Affordable Care Act: Exchange and Insurance Market Standards for 2015 and Beyond (CMS-9949-P)– Proposed Rule (RIN# 0938-AS02) – Centers for Medicare & Medicaid Services (CMS) – April 21, 2014
DRAFT CMS Quality Rating System Scoring Specifications– Guidance – Centers for Medicare & Medicaid Services (CMS) – April 28, 2014

2013

Patient Protection and Affordable Care Act: Establishment of Multi-State Plan Program for Affordable Insurance Exchanges– Proposed Rule (RIN# 3206-AM47) – Office of Personnel Management – January 3, 2013
Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (CMS-9979-P)– Proposed Rule (RIN#s 0938-AR48; 1210-AB55; 1545-BL07) – Centers for Medicare & Medicaid Services (CMS), Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS) – January 24, 2013
Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eli– Proposed Rule (RIN# 0938-AR04) – Centers for Medicare & Medicaid Services (CMS) – February 21, 2013
Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions (CMS-9958-P)– Proposed Rule (RIN# 0938-AR68) – Centers for Medicare & Medicaid Services (CMS) – March 18, 2013
Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel (CMS-9955-P)– Proposed Rule (RIN# 0938-AR75) – Centers for Medicare & Medicaid Services (CMS) – May 5, 2013
Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium Stabilization Programs, and Market Standards (CMS-9957-P)– Proposed Rule (RIN# 0938-AR82) – Centers for Medicare & Medicaid Services (CMS) – July 18, 2013
Agency Information Collection Activities: Submission for OMB Review; Comment Request (CMS-10466)– Request for Comments – Centers for Medicare & Medicaid Services (CMS) – November 15, 2013

2012

Patient Protection and Affordable Care Act: Health Insurance Market Rules; Rate Review (CMS-9972-P)– Proposed Rule (RIN# 0938-AR40) – Centers for Medicare & Medicaid Services (CMS) – December 25, 2012
Patient Protection and Affordable Care Act: Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (CMS-9980-P)– Proposed Rule (RIN# 0938-AR03) – Centers for Medicare & Medicaid Services (CMS) – December 25, 2012
Request for Information Regarding Qualified Health Plan Quality Management (CMS-9962-NC)– Request for Information – Centers for Medicare & Medicaid Services (CMS) – January 10, 2013
Patient Protection and Affordable Care Act: Benefit and Payment Parameters for 2014 (CMS-9964-P)– Proposed Rule (RIN# 0938-AR51) – Centers for Medicare & Medicaid Services (CMS) – December 30, 2012

2011

Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan (CO-OP) Program (CMS-9983-P)– Proposed Rule (RIN# 0938-AQ98) – Centers for Medicare & Medicaid Services (CMS) – September 15, 2011
Patient Protection and Affordable Care Act: Standards Related to Reinsurance, Risk Corridors and Risk Adjustment (CMS-9975-P)– Proposed Rule (RIN# 0938-AR07) – Centers for Medicare & Medicaid Services (CMS) – October 31, 2011
Patient Protection and Affordable Care Act: Establishment of Exchanges and Qualified Health Plans (CMS-9989-P)– Proposed Rule (RIN# 0938-AQ67) – Centers for Medicare & Medicaid Services (CMS) – October 31, 2011
Summary of Benefits and Coverage and Uniform Glossary: Templates, Instructions, and Related Materials under Public Health Service Act (CMS-9982-NC)– Request for Comments (RIN# 1210-AB52) – Centers for Medicare & Medicaid Services (CMS), Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS) – October 21, 2011
Medicaid Program; Eligibility Changes Under the Affordable Care Act of 2010 (CMS-2349-P)– Proposed Rule (RIN# CMS-2349-P) – Centers for Medicare & Medicaid Services (CMS) – October 31, 2011
Request for Information Regarding State Flexibility to Establish a Basic Health Program Under the Affordable Care Act– Request for Information – Centers for Medicare & Medicaid Services (CMS) – October 30, 2011
Health Insurance Premium Tax Credit (IRS REG-131491-10)– Proposed Rule (RIN# 1545-BJ82) – Internal Revenue Service (IRS) – October 31, 2011

2010

Planning and Establishment of State-Level Exchanges: Request for Comments Regarding Exchange-Related Provisions in Title I of Patient Protection and Affordable Care Act– Request for Comments – Centers for Medicare & Medicaid Services (CMS) – October 4, 2010

State Regulations

Covered California regulations that are in effect are published in the California Code of Regulations (CCR), Title 10, Chapter 12 The following regulatory actions are available for review.

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Regulation Resources

About the Affordable Care Act
U.S. Code of Federal Regulations
Federal Register
California Legislative Information — Titles 22–25 of the Government Code
California Code of Regulations — Title 10, Chapter 12
California Regulatory Notice Register
OAL Proposed Regulations Under Review
OAL Emergency Regulations Under Review

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