CMS issues final benefit and payment parameters for 2024 marketplace plans

The Centers for Medicare & Medicaid Services released its standards for qualified health plans offered through the health insurance marketplaces for 2024. CMS finalized with limited exceptions its proposal to require all plans (regardless of marketplace type) to comply with network adequacy and enhanced essential community provider standards, and add to the ECP standards mental health and substance use disorder treatment facilities, beginning in plan year 2024. In response to comments, CMS also finalized an amendment to the appointment wait time standards to delay application of the regulations until plan year 2025. CMS finalized requiring 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 limiting non-standardized options. In addition, CMS finalized several special enrollment period policies, including allowing marketplaces to choose to offer a special enrollment period to consumers losing minimum essential coverage through Medicaid or the Children’s Health Insurance Program. CMS also finalized accepting a household’s income attestation in lieu of tax return data; permitting assisters to conduct door-to-door enrollment; and changes to risk adjustment models and requirements for agents and brokers. The AHA offered support for many of these policies in its comment letter.