CMS issues proposed rule changing federal marketplace enrollment and eligibility requirements 

The Centers for Medicare & Medicaid Services March 10 released new proposed policies for health insurance marketplaces, including the issuers, agents and brokers who assist marketplace enrollees. If finalized, the rule would shorten the open enrollment period for all marketplaces to Nov. 1-Dec. 15 and address issues with brokers fraudulently enrolling individuals without their consent by ending a special enrollment period for low-income individuals. CMS also proposed a change to the premium adjustment percentage that would increase the maximum annual cost sharing limitation. The proposed rule includes updates to the income verification process and pre-enrollment verification process for SEPs, changes to the essential health benefits, and modifications to the redetermination and re-enrollment processes, among other policies. Many of the proposed policies would reinstate policies previously finalized during the prior Trump administration.   

AHA members will receive a Regulatory Advisory with further details.