The Centers for Medicare & Medicaid Services yesterday released its proposed standards for qualified health plans offered through the health insurance marketplaces for 2024. Beginning in plan year 2024, the proposed rule would require all plans (regardless of marketplace type) to comply with network adequacy and enhanced essential community provider (ECP) standards, and add to the ECP standards mental health and substance use disorder treatment facilities. The proposed rule also would require issuers selling on the federally-facilitated marketplace to offer standardized plan options for every network type, service area and metal level except the non-expanded bronze level; and limit non-standardized options or apply a meaningful difference standard. In addition, marketplaces could choose to offer a special enrollment period to consumers losing minimum essential coverage through Medicaid or the Children’s Health Insurance Program. CMS also proposes to accept a household’s income attestation in lieu of tax return data; permit assisters to conduct door-to-door enrollment; and make changes to risk adjustment models and requirements for agents and brokers.
CMS will accept comments on the rule for 45 days once it’s published in the Federal Register.