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qualified health plans

America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.

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qualified health plans

CMS has pushed back by seven weeks, to June 21, the deadline for qualified health plans to apply to participate in the ACA health insurance marketplaces in 2018.

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qualified health plans

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

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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.

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qualified health plans

America's Essential Hospitals expressed continued concerns about qualified health plan network adequacy in federally facilitated marketplaces.

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qualified health plans

The letter provides operational and technical guidance to issuers of qualified health plans through the federal health insurance marketplace for 2018.

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qualified health plans

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

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qualified health plans

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

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qualified health plans

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

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qualified health plans

Dec. 23 letter provides operational, technical guidance to qualified health plans (QHPs) and outlines network adequacy standards for plans offered through the federally facilitated health insurance marketplace.

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qualified health plans

Out-of-pocket expenses higher in ACA marketplaces and coverage worse for children, especially those with special needs, HHS reports.

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qualified health plans

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

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qualified health plans

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

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qualified health plans

Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.

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qualified health plans

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

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qualified health plans

The association submitted comments to CCIIO and NAIC calling for more robust standards for including ECPs in health insurance marketplaces.

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qualified health plans

America's Essential Hospitals urged HHS to improve ECP standards in the marketplaces to ensure patients have access to quality, affordable health care.

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qualified health 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.

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qualified health plans

The Labor/HHS appropriations bill vote was cancelled due to Republican threats to derail the process over ACA funding. House Majority Leader Cantor's loss has House Republicans vying for his seat. MedPAC shares its biannual report to Congress on Wednesday.

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qualified health plans

HHS reiterates that charitable foundations are not prohibited from making payments on behalf of enrollees in qualified health plans.

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qualified health plans

Comments include requests to allow provider-supplemented premium assistance and cost-sharing for individuals obtaining marketplace coverage and to clarify that QHPs should accept premium and cost-sharing assistance from private, nonprofit foundations.

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qualified health plans

CMS proposes that QHP issuers collect enrollee satisfaction data for certain QHPs. This data will be one of the components used to determine QHP quality ratings. America's Essential Hospitals will submit comments on CMS' proposal for collecting enrollee satisfaction data.

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qualified health plans

Labor, Treasury, and Health and Human Services seek comments on the ACA’s provider nondiscrimination provision. Their request includes information on access, costs, other federal and state laws, and feasibility. Comments are due by June 10.

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qualified health plans

CMS stated that it encourages QHPs to reject payments from hospitals and other health care providers. The agency did not provide information about premium and cost-sharing payments made on behalf of QHP enrollees by private, nonprofit foundations. America's Essential Hospitals will submit comments to CMS urging the agency to allow such payments from private, nonprofit foundations.

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qualified health plans

For 2015, each qualified health plan (QHP) network must include at least 30 percent (up from 20 percent in 2014) of all available ECPs in its service area to meet network adequacy requirements. CMS is also implementing a reasonable access review standard.

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qualified health plans

These FAQs further clarify the Nov. 4, 2013 FAQ, which stated that the U.S. Department of Health and Human Services encourages issuers to reject premium payments from third parties such as hospitals, other health care providers, and other commercial entities.

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qualified health plans

Responding to input from America’s Essential Hospitals to strengthen the essential community provider (ECP) requirements, CCIIO notes an enhanced ECP standard. America’s Essential Hospitals is pleased CCIIO recognizes that more protection is needed for ECP patients’ access to care but believes that the requirements should be strengthened further.

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qualified health plans

Of particular interest to members of America's Essential Hospitals, we are pleased to see CCIIO account for the concerns raised by our member hospitals and enhance its essential community provider standard.

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qualified health plans

About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

America’s Essential Hospitals was formerly known as the National Association of Public Hospitals and Health Systems (NAPH). Carrying our mission since 1981 into today's health care era

Learn more about the name change »