CMS final payment notice for the 2021 coverage year: 6 things to know

CMS issued its final Notice of Benefit and Payment Parameters for the 2021 benefit year for the ACA marketplace.

Six things to know:

1. The final rule keeps in place the user fee rates on health insurers that participate in the federal exchange platform that were set in the 2020 payment notice. The rates are 3 percent for plans on the federally facilitated exchange and 2.5 percent for plans on the state-based exchange on the federal platform.

2. The rule finalizes enhancements made to the periodic data matching processes to reduce the risk of sending incorrect subsidies to enrolled who are deceased or dually enrolled in Medicare. 

3. Policies around the annual reporting of state-required benefits that are required in addition to essential health benefits are strengthened under the rule, as states now have to notify CMS each year of additional state-required benefit mandates.

4. The rule requires states to cover the cost of any new state-mandated insurance benefits that are in addition to the ACA's essential health benefits.

5. CMS is also giving states that run their own health insurance exchanges more flexibility to customize how quality information is displayed for consumers.

6. Due to the COVID-19 pandemic, CMS is implementing a one-week extension of the Qualified Health Plan certification and rate review timelines.

Read the full rule here.

More articles on payers:
UnitedHealth to give members $1.5B in discounts
Humana waives costs for primary care, behavioral health visits for 4.5 million members
Hospitals get help from insurers with improved balance sheets

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