On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Webinar: Final 2017 Notice of Benefit and Payment Parameters and Letter to Federal Marketplace Issuers
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.