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.     
 

Headline
The administration Apri 23 reached a most-favored-nation drug pricing agreement with Regeneron, the maker of the popular cholesterol medicine Praluent. This is…
Headline
The AHA April 23 released a blog responding to a report issued April 22 by Paragon Health Institute. The blog highlights how the report relies on a long list…
Blog
Public
In think‑tank reports, like the one released this week by Paragon Health Institute, hospitals are often reduced to abstractions — payment rates, charts,…
Headline
The Centers for Medicare & Medicaid Services announced in a memo April 21that it is delaying implementation of the Medicare Part D portion of the Better…
Headline
The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…
Headline
Rep. Blake Moore, R-Utah, vice chair, House Republican Conference and member of the House Ways and Means Committee and its Subcommittee on Health, joined Bill…