CHA News Article

CMS Issues Proposed Annual Benefit and Payment Parameters for 2017
Proposed rule governs participation in health insurance marketplaces

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that sets forth payment parameters and provisions related to the risk adjustment, reinsurance and risk corridors programs; cost sharing parameters and cost sharing reductions; and user fees for federally facilitated exchanges. It also provides standards for the 2017 benefit year open enrollment period for the individual market; essential health benefits; cost sharing requirements; qualified health plan exchange consumer assistance programs; network adequacy; the Small Business Health Options Program; stand-alone dental plans; acceptance of third-party payments by qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; guaranteed availability; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics. Within the proposed rule, CMS also proposes to expand current regulations related to patient safety standards for hospitals. CHA is in the process of reviewing the proposed rule. Public comments are due to CMS by Dec. 21.