On November 25, 2020, the U.S. Departments of Health & Human Services (HHS) and Treasury released the proposed 2022 “Notice of Benefit & Payment Parameters” (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on several provisions that have implications for state oversight of insurance markets and the state-based marketplaces. Comments on the proposed rule are due by December 30, 2020.
Issuer Essential Health Benefits Crosswalk and Certification
Georgetown University Health Policy Institute
The Issuer Essential Health Benefits (EHB) Crosswalk and Certification has been developed by the Georgetown University Health Policy Institute to help insurance regulators ensure that product filings include the required EHBs as set forth in the applicable state benchmark plan. Regulators can use the tool provided here, requiring issuers to complete the Crosswalk and Certification by: (i) describing each benefit as set forth in the state’s benchmark plan (including applicable page numbers); (ii) describing the corresponding benefit in the issuer’s product filing (including applicable page numbers); and (iii) certifying that (a) the information in the Crosswalk and Certification is accurate and complete and (b) the product filing includes all required essential health benefits as set forth in the state’s benchmark plan. The issuer completed Crosswalk and Certification is intended to increase the efficiency of the form review process by allowing form reviewers to quickly find and verify that the product under review meets all applicable EHB requirements. The tool is word document format and is designed to be modified to meet state-specific needs.