The Centers for Medicare & Medicaid Services April 2 released its final rule for qualified health plans offered through the health insurance marketplaces for 2025. Beginning in plan year 2025, CMS will require plans participating in state-based marketplaces to comply with time and distance network adequacy standards that are at least as stringent as those for the federally facilitated marketplace. CMS also finalized several other changes to standardize and streamline operations, particularly for state-based marketplaces. In addition, CMS finalized policies intended to make it easier to enroll in coverage and improve access to services such as dental benefits and prescription drugs.

In January, AHA voiced support for the agency’s proposals to strengthen network adequacy standards, standardize and streamline marketplace operations, ease the enrollment process and improve access to certain health care services in the proposed rule

Blog
Public
Patients are best served when insurers act as transparent and reasonable partners, not when they invoke patient protection laws to justify payment strategies…
Headline
The AHA shared the following statement with the media in response to a report released May 7 by Families USA.   “This report is long on rhetoric and…
Headline
The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…
Headline
Rep. Greg Landsman, D-Ohio, a member of the House Energy and Commerce Committee and its Subcommittee on Health, spoke with Mike Abrams, president and CEO of…
Headline
Americans across 43 states enrolled in health plans from the nation’s four largest commercial health insurers face potential disparities in finding in-network…
Headline
Average out-of-pocket premiums for Health Insurance Marketplace enrollees increased $65 per month in 2026 compared to 2025, going from $113 to $178, according…