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CCIIO Finalizes 2015 QHP Issuer Letter

The Center for Consumer Information and Insurance Oversight (CCIIO) finalized and released on March 14 a letter providing guidance to issuers that plan to offer qualified health plans (QHPs) in federally facilitated marketplaces (FFMs) in 2015. In the letter, CCIIO finalized the enhanced essential community provider (ECP) guideline that requires each QHP network to include at least 30 percent (up from 20 percent in 2014) of all available ECPs in its service area to meet FFM network adequacy requirements.

America’s Essential Hospitals is pleased CCIIO increased its ECP standard but believes CCIIO should require issuers to offer QHP contracts to every willing ECP in each county of the plan’s service area.

In addition, CCIIO stated that it will implement a reasonable access review standard, which will help the agency identify plan networks that do not ensure timely access to care. CCIIO is considering how to collect provider network data to help with this review.

Please contact Xiaoyi Huang, director of policy, at xhuang@essentialhospitals.org or 202.585.0127 with questions.

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