CMS issued the 2021 notice of benefit and payment parameters proposed rule and draft letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS is not proposing any changes to network adequacy standards.

America's Essential Hospitals praised the administration’s efforts to streamline managed care regulations for Medicaid and the Children's Health Insurance Program, reduce regulatory burden, and increase state flexibility.

The proposed rule reflects the agency’s broader strategy to relieve regulatory burden, support state flexibility, and promote transparency and innovation in the delivery of care. We encourage all members to review the proposed rule, give us feedback, and submit your own comments to CMS.

The new guidance outlines the types of rules association health plans must follow under the Employee Retirement Income Security Act and reiterates that states and the Department of Labor have a joint responsibility to regulate such plans.

The Department of Labor has issued a final rule expanding the definition of "employer" for purposes of establishing association health plans.

In a March 6 comment letter, America's Essential Hospitals urged federal officials to ensure association health plans have proper oversight and cover all necessary services for beneficiaries.

The proposed rule aims to provide flexibility by targeting network adequacy reviews & inclusion of essential community providers in qualified health plans.

CMS finalized a proposal to continue the current methodology, which qualified health plans use to satisfy the minimum essential community provider standard.

Hospitals eligible for the essential community providers list are participants in the 340B and DSH programs, critical access hospitals, and others.

Comments on the proposed Notice of Benefit and Payment Parameters for 2018 are due by Oct. 6.

HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.

Comments urge CCIIO to require that ACA marketplace plans include willing essential community provider (ECP) hospitals and ensure payment rates support access to care.

Proposals would make required and recommended changes to how qualified health plans operate in Affordable Care Act marketplaces.

Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.

Recent narrowing of provider networks in Medicare Advantage (MA) organizations, which privately offer one or more health benefit plans to Medicare beneficiaries, has caused concerns over whether MA enrollees can adequately access care.