Update on Same Sex Marriage Laws: CMS FAQ on Coverage of Same-Sex Spouses.


By: Johanna Montero-Okon

On March 14, 2014, the Department of Health and Human Services, Centers for Medicare and Medicaid Services, published a Frequently Asked Question (“FAQ”) regarding the coverage of Same-Sex Spouses. FAQ’s are generally published by the Departments for the purpose of providing further regulatory guidance by explaining or addressing specific questions the public may have on regulations or the rulemaking process.

Specifically, this FAQ is intended to address questions related to the Department’s Final Regulations published on February 27, 2013. The final regulations implement section 2702 of the Public Health Service Act, which requires that some health insurance issuers offering coverage in the group or individual markets guarantee availability of coverage unless an exception applies. In addition, pursuant to the required availability requirements and the final regulations at 45 CFR 147.104(e), the preamble to the final regulations provides that, in doing so, health insurance issuers are prohibited from implementing discriminatory marketing practices or benefit designs. The goal is to ensure that insurance companies subject to the regulations do not discriminate against same-sex married couples, but instead offer them the same benefits extended to heterosexual married couples. As provided by the Department, the FAQ should clarify the meaning of the terms used in 45 CFR. 104(e). Furthermore, the answers provided by the Department should assist health insurance issuers seeking additional guidance on the requirements they must meet to ensure availability of coverage.


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