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.
New Hampshire COVID-19 Directed Payment
Jocelyn Guyer and Patricia Boozang, Manatt Health
On April 30, 2020, New Hampshire received approval from the Centers for Medicare & Medicaid Services (CMS) to require its managed care organizations (MCOs) to make a directed payment to six types of essential Medicaid providers in order to help them keep their doors open during the COVID-19 pandemic. Numerous states across the country share New Hampshire’s interest in directing MCOs to use some of their capitation funds to support providers facing sharp declines in utilization due to COVID-19. This regulatory analysis provides an overview of New Hampshire’s directed payment and the documents used in the New Hampshire approval.