District court pauses 8 provisions from 2027 notice of benefit and payment parameters final rule

The U.S. District Court for the District of Maryland July 16 enjoined eight provisions from the Centers for Medicare & Medicaid Services’ 2027 notice of benefit and payment parameters final rule, which were set to become effective July 20. The final rule issues standards for qualified health plans offered through the health insurance marketplaces. The injunction pauses multiple policies that the AHA previously raised concerns about, including an expansion of annual out-of-pocket maximums for certain bronze and catastrophic plans; expanded eligibility for catastrophic plans; relaxation of federal network adequacy requirements; and the creation of a pathway for non-network plans to qualify as Health Insurance Marketplace coverage. 

The court concluded that the plaintiffs demonstrated a likelihood of success on their Administrative Procedure Act claims, would suffer irreparable harm without relief, and that the balance of equities and public interest favored a stay.

The remainder of the final rule is taking effect as scheduled on July 20.