Good afternoon - Today, the Centers
for Medicare & Medicaid Services (CMS) issued the final
2017 HHS Notice of Benefit and Payment Parameters for the 2017 coverage year,
along with related guidance documents, as part of our ongoing efforts to
promote healthy and stable markets that works for consumers and for insurers.
The rule finalizes provisions to:
help consumers with surprise out-of-network costs at in-network facilities,
provide consumers with notifications when a provider network changes, give
insurance companies the option to offer plans with standardized cost-sharing
structures, provide a rating on HealthCare.gov of each QHP’s relative network
breadth (for example, “basic,” “standard,” and “broad”) to support more
informed consumer decision-making, and improve the risk adjustment
formula.
To help stakeholders plan ahead,
CMS also finalized the open enrollment period for future years. For coverage in
2017 and 2018, open enrollment will begin on November 1 of the previous year
and run through January 31 of the coverage year. For coverage in 2019 and
beyond, open enrollment will begin on November 1 and end on December 15 of the
preceding year (for example, November 1, 2018 through December 15, 2018 for
2019 coverage).
The fact sheet with details on
these key provisions and others can be found here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-29.html.
In
addition to the final Notice of Benefit and Payment Parameters for 2017, CMS released its final Annual Letter to Issuers.
This provides issuers interested in offering coverage in states with a
Federally-facilitated Marketplace information on key dates for the
Qualified Health Plan (QHP) certification process; standards that will be used
to evaluate QHPs for certification; and oversight procedures, consumer support
policies and programs. The letter is available here: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-2017-Letter-to-Issuers-2-29-16.pdf
Additionally,
CMS released a bulletin on the Rate Filing Justifications for the 2016 Filing
Year for Single Risk Pool Compliant Coverage. This bulletin provides guidance
on the timing for state Departments of Insurance and health insurance insurers
to submit Rate Filing Justifications for proposed rate increases in the
individual and small group markets. The guidance, which offers states greater
flexibility than the proposed bulletin, is available here: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-rate-filing-justification-bulletin-2-29-16.pdf
Key Dates for the 2016
calendar year: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-2016-key-dates-table-2-29-16.pdf
CMS
released a set of Frequently Asked Questions (FAQs) related to the Moratorium
on the Health Insurance Provider Fee (enacted in the Consolidated
Appropriations Act of 2016, P.L. 114-113), which suspends collection of this
fee for the 2017 plan year. This guidance urges issuers to lower their administrative costs and premiums appropriately to
account for the moratorium. The FAQs are
available here: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FINAL_9010_FAQ_2-29-16.pdf.
Lastly, CMS released guidance
addressing the transitional policy for plans that have been continuously
renewed since 2014. To allow for a smooth wind-down of transition relief,
States and issuers will have the option to renew non-grandfathered individual
and small group health policies, but these policies must end no later than
December 31, 2017. This approach offers flexibility to States and issuers
to align the end of these policies with open enrollment and the start of the
calendar year, facilitating smooth transitions to Affordable Care Act-compliant
policies. The guidance is available here: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/final-transition-bulletin-2-29-16.pdf
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