AHA comments on proposed QHP, Marketplace standards for 2017

The AHA supports the stronger network adequacy standards proposed for qualified health plans in the 2017 Health Insurance Marketplace, but urged the Centers for Medicare & Medicaid Services to apply all network adequacy standards to the lowest cost-sharing tier of any tiered network to prevent discriminatory or inadequate plan designs. Commenting Friday on the proposed standards for health insurance issuers and Health Insurance Marketplaces in 2017, AHA Executive Vice President Tom Nickels also urged that the final rule require QHPs to accept third-party premium and cost-sharing payments from hospitals, hospital-affiliated foundations and other charitable organizations, and expand protections for consumers who receive covered services by out-of-network providers. In a separate letter focused on the proposed patient safety standards for QHPs, AHA generally supports the agency’s framework for implementing the second phase of the standards, but said the proposals related to discharge planning “are duplicative and would increase burden without adding value.” The association also urged the agency “to ensure that mechanisms for compliance are as efficient and consistent as possible for hospitals.”