CMS Issues Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2024; Comments Due January 30
Published December 21, 2022
The Centers for Medicare & Medicaid Services (CMS) has released the proposed annual Notice of Benefit and Payment Parameters for the 2024 benefit year. The notice applies to issuers and Marketplaces, as well as requirements for agents, brokers, web-brokers, and assisters that help consumers with enrollment through Marketplaces and affects individual market qualified health plans, standalone dental plans, and all Small Business Health Option Program (SHOP) plans. The proposed rules aim to increase consumer access to health care services, simplify choice and improve the plan selection process to make it easier to enroll in coverage.
Some highlights include:
- Expanded access to behavioral health care, including two new insurer categories for essential community provider (ECP): Substance Use Disorder Treatment Centers and Mental Health Facilities
- Limiting the number of nonstandardized plan options that issuers can provide on exchanges and increase the availability of standardized plans that are required to standardize their deductibles, out-of-pocket maximum and cost-sharing for plans with the same coverage metals
- Allowing Marketplaces the option to implement a new rule for a special enrollment period (SEP) for those losing Medicaid or Children’s Health Insurance Program (CHIP) coverage, giving consumers 60 days before or 90 days after a loss of Medicaid or CHIP coverage to select a Marketplace plan
- A risk adjustment user fee for the 2024 benefit year of $0.21 per member per month.
Comments are January 30, 2023.
Additional Information:
Key Dates for Calendar Year 2023 for QHP Certification, Rate Review, and Risk Adjustment