The AHA today submitted comments to the Centers for Medicare & Medicaid Services on the agency's proposed notice of benefit and payment parameters for the 2019 health insurance marketplaces. "While we appreciate CMS's efforts to reduce regulatory burden within the health care system and provide states with increased flexibility, we are concerned that several of the proposals in the rule would reduce patient access to care, including some that could result in health plans that cover fewer benefits and expose patients to greater cost sharing," wrote AHA Executive Vice President Tom Nickels. Specifically, AHA urged CMS to abandon a proposal providing states with more flexibility on setting the essential health benefits package. "Patients would face higher out-of-pocket costs for services no longer covered, which also would not be subject to cost-sharing limits or prohibitions on annual or lifetime limits," AHA said. In addition, AHA expressed concerns with proposals related to network adequacy standards and essential community providers; medical loss ratio; and the navigator program. AHA expressed support for proposals related to special enrollment periods and minimal essential coverage designation for Children's Health Insurance Program buy-in programs. 

Related News Articles

Headline
The median net launch price for 154 new drugs increased 51% between 2022 and 2024, after accounting for inflation and discounts, according to a report released…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
Annual premiums for employer-sponsored family health coverage in 2025 increased 6% over last year to $26,993, according to KFF’s annual Employer Health…
Headline
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…
Headline
The AHA today released the Health Plan Accountability Update for the third quarter of 2025. The update covers the latest developments in Medicare…
Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…