CMS issues proposed notice of benefit and payment parameters for 2025

Nov 16, 2023 - 04:03 PM
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The Centers for Medicare & Medicaid Services Nov. 15 released its proposed standards for qualified health plans offered through the health insurance marketplaces for 2025. Beginning in plan year 2025, the proposed rule would require state-based marketplaces (SBM) to comply with time and distance network adequacy standards for qualified health plans that are at least as stringent as those for the federally facilitated marketplace. CMS also proposes several other changes to standardize and streamline marketplace operations, particularly SBM operations, such as changes related to call center standards and SBM eligibility and enrollment platforms. CMS also proposes policies intended to make it easier to enroll in coverage and improve access to services such as dental benefits and prescription drugs. At the same time, CMS released the draft letter to issuers, proposed 2025 actuarial value calculator, and premium adjustment percentage guidance for the 2025 benefit year.     
 

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