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.
Issue Spotting Common Policy and Operational Barriers to Ex Parte Renewals: State Assessment Tool
Patti Boozang, Kinda Serafi, Kaylee O’Connor, and Michelle Savuto, Manatt Health
Many states are actively working to make changes to their systems to enable ex parte renewals at the individual level and implement mitigation strategies to ensure eligible Medicaid and CHIP enrollees retain coverage until those system changes are complete. As states take on this work, they have an opportunity to assess end-to-end renewal functionality to identify additional policy and operational changes that could increase ex parte rates and streamline renewals (and relatedly, perhaps, streamline initial eligibility determinations). This tool is intended to: (1) help states identify common policies and/or operational processes that, if adjusted, could improve ex parte rates and renewal functionality, and (2) facilitate internal, cross-divisional Medicaid agency discussions across policy, operational, and information technology systems.