The Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a proposed rule for 2018 that proposes reforms critical to stabilizing the individual and small group health insurance markets to help protect patients.
This proposed rule would make changes to special enrollment periods, the annual open enrollment period, guaranteed availability, network adequacy rules, essential community providers and actuarial value requirements. It also notes upcoming changes to the qualified health plan certification timeline.
Acting CMS administrator Dr. Patrick Conway said the proposed rule “will take steps to stabilize the marketplace, provide more flexibility to states and insurers and give patients access to more coverage options.”
The rule proposes to:
- Shorten the open enrollment period
- Require pre-enrollment verification
- Require payment of past coverage debt before applicants re-enroll, incentivizing patients to avoid coverage lapses
- Make adjustments to the used for determining the level of coverage, therby including less expensive plans with lower coverage levels
- Give states greater oversight of provider networks
- Allow insurers to write in essential community providers
