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.
Updated: Medicaid State Plan Amendment Requirements of the Affordable Care Act
Center for Health Care Strategies
A number of provisions in the Affordable Care Act (ACA), from changes to income eligibility (section 2002) to coverage for freestanding birth center services (section 2301), require states to alter Medicaid eligibility guidelines, service benefits, or payment criteria. To assist in determining which provisions require states to submit amendments to their Medicaid state plan, the Center for Health Care Strategies, with support from the State Network, has developed a resource which catalogs required and optional provisions that may require amendments, including links to the applicable ACA text, deadlines for approval, and available guidance. The hyperlinks within the document link directly to the specific sections of ACA referenced and to supporting documentation for those sections where available. States may use this document to plan sufficient time for development, stakeholder engagement, submission and approval of the applicable amendments to CMS.
This document has been updated as of July 2013 to reflect the latest guidance.