On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
Individual Eligibility Appeals Webinar
Melinda Dutton, Partner, Manatt Health Solutions Kinda Serafi, Counsel, Manatt Health Solutions
Introduction & Overview
The State Coverage Initiatives program, in coordination with the State Network, hosted a webinar on September 23, 2013 that discussed individual eligibility appeals. Melinda Dutton and Kinda Serafi from Manatt Health Solutions facilitated this webinar with state respondents from Illinois and Rhode Island. The webinar provided an overview of appeals requirements put forth in the regulations, including:
-State options for delegation of MAGI Medicaid and Exchange appeals;
-The standards for components of the appeal process, such as for appeal notices, appeal requests, pended benefits, informal resolution, hearings, and appeal decisions;
-The due process and procedural rights of the appellant; and
-Requirements for coordination between agencies and appeals entities.
The webinar slides can be found at the “download” button and a webinar recording can be found here.