CMS finalizes 2017 health insurance marketplace improvements
Rule finalizes provisions to help consumers with surprise out-of-network costs, CMS says
The Centers for Medicare and Medicaid Services on Monday issued its final annual notice of benefit and payment parameters for the 2017 health insurance marketplace.
The rule finalizes provisions to help consumers with surprise out-of-network costs at in-network facilities, CMS said.
It also gives consumers notification when a provider network changes, give insurance companies the option to offer plans with standardized cost-sharing structures, provides a rating on Healthcare.gov of each qualified health plan's relative network breadth in terms such as basic, standard and broad.
The goal is to support more informed consumer decision-making, and to improve the risk adjustment formula, CMS said.
CMS finalized future open enrollment periods. For coverage in 2017 and 2018, open enrollment will begin on November 1 of the previous year and run through January 31 of the coverage year.
For coverage in 2019 and beyond, open enrollment will begin on November 1 and end on December 15 of the preceding year - for example, November 1, 2018 through December 15, 2018 for 2019 coverage.
CMS also released its final annual letter to issuers in states with a federally-facilitated marketplace. It contained information on key dates for qualified health plans and standards to evaluate them for certification, along with oversight procedures and consumer support policies and programs.
Additionally, CMS released a bulletin providing guidance on the timing for state Departments of Insurance and health insurance insurers to submit justifications for proposed rate increases in the individual and small group markets.
CMS released a set of frequently asked questions related to the moratorium on the health insurance provider fee, which suspends collection of this fee in 2017. This guidance urges issuers to lower their administrative costs and premiums appropriately to account for the moratorium, CMS said.
Lastly, CMS released guidance addressing the transitional policy for plans that have been continuously renewed since 2014. States and issuers will have the option to renew non-grandfathered, individual and small group health policies, but these policies must end no later than December 31, 2017, CMS said. This is to offer flexibility to states and issuers to align the end of these policies with open enrollment and the start of the calendar year.
Matthew Eyles, executive vice president, Policy and Regulatory Affairs at America's Health Insurance Plans said CMS has taken positive steps to provide greater stability in the exchanges in 2017.
However, he said, "We must stay focused on policies and solutions that promote choice and affordability for consumers in the future. We will closely review the final notice against these two goals. Choice and affordability are fundamental to consumers and critical for the stability of the market in the long run."
