Today, the Biden-Harris administration, through the Centers for Medicare & Medicaid Services (CMS), announced measures that will make coverage more accessible, expand access to behavioral health care, simplify choice and will make it easier for millions of Americans to choose health. forecast in 2024.

“The Biden-Harris administration has worked tirelessly to expand access to health insurance and lower health care costs for American families,” HHS Secretary Xavier Becerra said. “Today’s announcement of the 2024 Notice Final Rule on Benefits and Payment Metrics is a step towards creating a health care system that puts people first.” equity, access and affordability. HHS remains committed to removing barriers to care to ensure quality health care is available to all who need it.

“We’ve made great strides with record insurance rates, but affordable health care remains a concern across the country,” CMS Administrator Chiquita Brooks-LaSure said. “As we continue to work toward accessible and equitable health care for all Americans, the Final Rule of Benefits Notice and Payment Settings of 2024 we are finalizing today will make it easier to access, choose and maintaining the health coverage that best suits their needs. needs.”

The Notice of Benefits and Payment Parameters Final Rule of 2024 (Notice of Final Payment 2024) finalizes standards for issuers and marketplaces, as well as requirements for agents, brokers, online and assistants that help consumers register through marketplaces that use the federal platform. These changes reinforce the Biden-Harris administration’s goals of advancing health equity by addressing the health disparities that underpin our health care system, such as strengthening health adequacy standards. network and the creation of a new Special Enrollment Period (SEP) for those who lose Medicaid or the Children’s Health Insurance Plan. (CHIP), among others. The rule also builds on the Affordable Care Act by expanding access to affordable, quality health care and coverage, especially behavioral health care, and by making it easier to select and enroll in health coverage.

Facilitate coverage enrollment

While the administration previously announced a temporary SEP for people losing Medicaid or CHIP through July 31, 2024 in recognition of the end of the continuous coverage requirement in Medicaid, the final rule establishes a permanent policy. Beginning January 1, 2024, Federally Facilitated Marketplaces (FFMs) and State-Based Marketplaces (SBMs) will have the ability to implement a new SEP for individuals who lose Medicaid coverage. or CHIP, allowing consumers to select a Marketplace coverage plan 60 days before, or 90 days after, losing Medicaid or CHIP coverage. This SEP aims to reduce coverage gaps and allows for a more seamless transition to Marketplace coverage.

The final rule also allows assistants to provide more convenient and efficient help to consumers. Assistants currently conduct direct outreach, education, and appointment follow-up, but are generally prohibited from providing registration assistance during an initial interaction if initiated by the Assistant. Removing this barrier will make it easier for consumers to get help when enrolling in coverage. Additionally, this policy change will likely improve health literacy in rural and underserved communities and reduce consumer burden, especially for consumers with a lack of access transportation, rigid work schedules, and those who are immunocompromised.

Increase access to health care services

Expanding access to behavioral health care remains a top priority for the Biden-Harris administration. As part of this effort, the Final Rule includes two new categories of Essential Community Providers (ECPs) who are critical to providing needed behavioral health care: substance use disorder treatment centers and residential care facilities. Mental Health.

The final rule will also help expand access to care by expanding the requirement for plans to contract with at least 35% of available CERBs in a plan’s service area to apply to two individual categories of CERBs: federally licensed health centers and family planning providers. The overall threshold of 35% also remains in place. These changes, in conjunction with other expanded network adequacy requirements in the final rule, increase provider choice, advance health equity, and expand access to care for consumers who have low income, complex or chronic health conditions, or who reside in underserved areas, as these consumers are often disproportionately impacted by unforeseen costs associated with out-of-network providers and limited access to providers.

Simplify choice and improve the plan selection process

The final rule includes provisions to make it easier for consumers to choose a health plan that best suits their individual needs and budget by refining designs for standardized plan options. The final rule also limits the number of non-standardized plan options offered by Qualified Health Plan Issuers (QHPs) through FFMs and SBMs on the Federal Platform (SBM-FP) to four in each area for l plan year 2024. This will reduce diet choice overload while continuing to provide consumers with a significant number of options to help meet their health needs.

For more information on the final rule, see the fact sheet: https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2024-final-rule

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