Regulatory Analysis , Webinars | Mar 11, 2016

Webinar: Final 2017 Notice of Benefit and Payment Parameters and Letter to Federal Marketplace Issuers

Manatt Health

The Department of Health and Human Services (HHS) recently published its final Notice of Benefit and Payment Parameters for 2017, as well as the final version of its 2017 letter to Qualified Health Plan (QHP) issuers participating in the federally-facilitated marketplace (FFM).  The State Network team at Manatt Health led a webinar explaining this final rule and what it will mean for states.  Key features of the rule discussed in this webinar presentation included new policies such as establishing voluntary standardized cost-sharing designs, protections against surprise bills from out-of-network providers, and a mechanism for state-based marketplaces (SBMs) to use the federal technology platform.  HHS has also revised its approach to network adequacy based on comments on the draft payment notice that had been published in November.


Expert Perspectives

October 11, 2024

CMS Offers New Details on Account Transfer 2.0

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

CMS Solicits Comments on Medicaid/CHIP Reporting Templates for Mental Health and Substance Use Disorder Parity

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

September 27, 2024

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

On April 2, 2024, the Centers for Medicare & Medicaid Services offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. While there are multiple drivers of inequities in oral health, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. This expert perspective provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.