CMS-0057 & Policy
Impacted Payer
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
The notable absences define the market's shape: commercial employer plans (fully insured off-Exchange and self-funded), Medicare FFS itself, and SBE-only QHP issuers are not directly covered. Multi-line payers typically standardize on the rule anyway rather than run bifurcated UM operations.