The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.

In response to the proposed rule for the 2023 plan year, the association urged the Department of Health and Human Services to ensure equitable access, finalize nondiscrimination policies, standardize collection of Z codes, and prorate premiums and advanced premium tax credits.

The Centers for Medicare & Medicaid Services is awarding $8.1 million in targeted funding to assess and potentially alter states’ essential health benefits packages.

The calendar year 2019 draft letter to plans offered through federally facilitated marketplaces also provides deadlines for qualified health plan certification.

The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.

The proposed rule would expand the role of states in administering marketplace plans and give states additional flexibility to define essential health benefits.

When lawmakers return, they could attempt to make additional changes to pass the American Health Care Act, legislation to repeal and replace the ACA.

Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

CMS, NAIC documents contain important health insurance marketplace provisions, including cost-sharing requirements. Comments due to CMS Dec. 22, to NAIC by Jan. 12, 2015.

The Affordable Care Act establishes state-based and regional health insurance exchanges

Qualified health plans must offer coverage in 10 care categories, including ambulatory and emergency

Also releases report that details how rule affects mental health, substance abuse disorder benefits

Urges CMS to keep nation's safety net in mind as agency fine tunes marketplace framework