At the end of last week, CMS issued the final rules designed to stabilize the ACA marketplaces. Previously, we reported when CMS had issued the proposed rules where they were seeking comments. The final rules establish important dates and guidelines regarding the length of next year’s open enrollment period, verification for Special Enrollment Periods (SEPs) and the role HHS will play in network adequacy rules, to name a few. Highlights from the rules include:
- The open enrollment period for 2018 will run from November 1-December 15, 2017 (previously open enrollment was set to last until January 31).
- Beginning in June, consumers attempting to enroll through a SEP will be required to provide documentation to verify they are entitled to the SEP.
- Consumers enrolling through a SEP will be restricted from changing metal levels.
- The states will be responsible for determining the network adequacy of plans offered. Network adequacy for qualified health plans will be judged based on accreditation boards where states are without authority to regulate network adequacy.
To read the CMS press release on the release of the final rules, click here. To download the rules, click here. For a more thorough discussion of the final rules, check out the blog post by Tim Jost on Health Affairs.
AAHD had submitted comments on the proposed rules and those comments are available here.