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.
Risk Adjustment and Reinsurance: A Work Plan for State Officials Webinar
Wakely Consulting Group – Ross Winkelman, Mary Hegemann and Syed Mehmud
Parallel with the release of the issue brief of the same name, Ross Winkelman and colleagues from Wakely Consulting led a webinar explaining what decisions states need to make over the next two years to ensure a robust risk adjustment and reinsurance program. The slides include color coded timelines for various state scenarios. Data needs and availability were also discussed, along with the role of insurance carriers in the risk adjustment and reinsurance program development process.