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.
 

Related News Articles

Headline
The AHA today participated in a panel discussion during a conference hosted by The Capitol Forum on the impact of insurer vertical integration. Molly Smith,…
Headline
The Department of Health and Human Services Office of Inspector General yesterday issued an alert warning of marketing schemes by certain Medicare Advantage…
Headline
The Congressional Budget Office Dec. 5 informed Congress that 2.2 million consumers would lose their health insurance in 2026 if enhanced premium subsidies are…
Headline
A $2.8 billion settlement from Blue Cross Blue Shield to health care providers resolving a 12-year antitrust lawsuit received preliminary approval yesterday…
Headline
The Department of Health and Human Services' Government Accountability Office Nov. 14 released a report that determined the private health insurance market…
Headline
In comments Nov. 11 to the Centers for Medicare & Medicaid Services on its Notice of Benefit and Payment Parameters for 2026, the AHA expressed support for…