A. The Commission shall have all the powers necessary to implement the provisions of this chapter and is specifically authorized to:

Terms Used In Virginia Code 38.2-6601

  • Benefit year: means the calendar year for which an eligible carrier provides coverage through an individual health benefit plan. See Virginia Code 38.2-6600
  • Commission: means the State Corporation Commission. See Virginia Code 38.2-100
  • Payment parameters: means the attachment point, reinsurance cap, and coinsurance rate for the Program. See Virginia Code 38.2-6600
  • Program: means the Commonwealth Health Reinsurance Program established pursuant to this chapter. See Virginia Code 38.2-6600
  • State: means any commonwealth, state, territory, district or insular possession of the United States. See Virginia Code 38.2-100
  • State Innovation Waiver: means a waiver of one or more requirements of the Affordable Care Act authorized by § 1332 of the Affordable Care Act, 42 U. See Virginia Code 38.2-6600

1. Enter into contracts as necessary or proper to carry out the provisions and purposes of this chapter, including contracts for the administration of the Program, as well as other approved initiatives under the State Innovation Waiver, and with appropriate administrative staff, consultants, and legal counsel;

2. Take action as necessary to avoid the payment of improper claims under the Program;

3. Establish administrative and accounting procedures for the operation of the Program and other approved initiatives under the State Innovation Waiver;

4. Establish procedures and standards for eligible carriers to submit claims under the Program;

5. Establish or adjust the payment parameters in accordance with subdivision B 2 of § 38.2-6602 for each benefit year;

6. Apply for a State Innovation Waiver, federal funds, or both, in accordance with § 38.2-6606, for the implementation and operation of the Program, as well as other initiatives designated by the established work group convened by the Secretary of Health and Human Resources;

7. Apply for, accept, administer, and expend gifts, grants, and donations and any federal funds that become available for the operation of the Program, as well as other initiatives designated by the established work group convened by the Secretary of Health and Human Resources; and

8. Adopt rules as necessary to implement, administer, and enforce this chapter, including rules necessary to align state law with any federal program.

B. If the State Innovation Waiver is granted pursuant to § 38.2-6606, the Commission, during implementation of the Program, shall evaluate the effect of the Program on access to affordable, high-value health insurance for consumers who are eligible for premium tax credit subsidies and cost-sharing reductions.

2021, Sp. Sess. I, c. 480.