CMS Releases Draft 2017 Letter To Issuers In The Federally Facilitated Marketplaces

Implementing Health Reform. On December 23, 2017, the Centers for Medicare and Medicaid Services (CMS) released its draft 2017 Letter to Issuers in the Federally Facilitated Marketplaces (FFMs). CMS also released a draft bulletin on the timing of rate filing submissions and rate filings for January 1, 2017 non-grandfathered individual and small group plans and a table of key dates for qualified health plan (QHP) certification, rate review, risk adjustment, and reinsurance for 2017. The Draft Letter To Issuers CMS issues a draft letter to FFM insurers (the “draft letter”) late each year following the release of its proposed benefit and payment parameters rule (the “proposed payment rule”). The letter to issuers is finalized early the following year, and it governs health plans in the federal marketplace for the next year, in this case 2017. This provides guidance for insurers as they formulate their health plans offerings. Much of the letter to issuers is process oriented; it tells insurers what information they have to file where and when. Other sections of the letter largely repeat information found in the 2016 or 2015 letters to issuers as the operation of the marketplaces become more and more routine. But other sections of the letter lay out in greater detail new initiatives identified in the payment rule. In the case of the 2017 letter, provisions on network adequacy, discriminatory benefit design, and formulary review are of particular interest. Application Of ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Medicaid and CHIP Medicare Payment Policy cost-sharing reductions essential community providers Essential Health Benefits Federally Facilitated Marketplace Provider Participation Rate QHPs SHOP exchanges Source Type: blogs