New CMS rule aims to make ACA coverage more accessible, affordable

CMS released the Notice of Benefit and Payment Parameters for 2023 Final Rule April 28, with changes aiming to make ACA coverage more accessible and affordable. 

In an April 28 news release, HHS said that the measures included in the final rule set the landscape for the upcoming HealthCare.Gov open enrollment period that begins Nov. 1.

The rule helps simplify the consumer shopping experience by establishing standardized plan options for issuers offering qualified health plans, according to the news release. 

The rule standardizes maximum out-of-pocket limits, deductible and cost-sharing features to allow easier comparison of plan attributes such as premiums and prescription drug coverage. 

Issuers offering qualified health plans will be required to offer standardized plan options of every network type, at every metal level and throughout every service area where nonstandardized options are offered starting next year.

The rule also requires qualified health plans to ensure certain classes of providers are available within required time and distance parameters.. Starting in 2024, these plans must ensure that providers meet minimum appointment wait time standards.  

CMS is also increasing the essential community provider threshold, which it said will increase access to a variety of providers for consumers who have low incomes or are medically underserved.

User fees for federal and state-based marketplaces on the federal platform will remain at the 2022 level in 2023, CMS said.

Read more about the final rule here.  

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