December 02, 2015

New Proposed Rules for the ACA Marketplaces and Plans

On November 20, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule, "Notice of Benefit and Payment Parameters for 2017," governing multiple aspects of ACA plans and Exchanges (a.k.a., Marketplaces). Among other topics, the Notice proposes an expanded role for Navigators (see this blog post from the Georgetown Center on Children and Families), the establishment of standardized Qualified Health Plans (QHPs) so that consumers can more easily compare plans across insurers, and a number of new requirements regarding network adequacy (such as federal standards that would include at least time and distance metrics). See this CMS press release for details, this CMS fact sheet for more details, and this blog post from Health Affairs for even MORE details and analysis. CMS is seeking comments on a number of its proposals, including those regarding network adequacy. Comments on the proposed rule are due December 21 and can be submitted at Disability groups and children's health groups, including Family Voices, will work in concert to develop comments.