Health Insurance Marketplace Update February 24, 2023

Centers for Medicare & Medicaid Services (CMS) sent this bulletin at 02/24/2023 03:44 PM EST

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Health Insurance Marketplace Weekly Update. Keeping states informed on their journeys toward implementing health reform.

February 24, 2023

THIS WEEK'S UPDATE

Draft 2023 Call Letter for the Marketplace Quality Rating System and QHP Enrollee Survey Now Available for Public Comment
Call for Nominations for the QRS/Quality Improvement Strategy Technical Expert Panel

Draft 2023 Call Letter for the Marketplace Quality Rating System and QHP Enrollee Survey Now Available for Public Comment

The Centers for Medicare and Medicaid Services (CMS) seeks public comment on proposed refinements to the Marketplace Quality Rating System (QRS) and the Qualified Health Plan (QHP) Enrollee Survey program included in the Draft 2023 Call Letter for the Quality Rating System and the Qualified Health Plan Enrollee Experience Survey. This document communicates proposed changes to the QRS and QHP Enrollee Survey and requests comments on these proposed refinements.

In the Draft 2023 Call Letter, CMS is requesting feedback on topics such as CMS’s newly developed Adult and Pediatric “Universal Foundation” measure sets and refinements to the QRS measure set, as well as updates to advancing health equity, Electronic Clinical Data System reporting, and the QHP Enrollee Survey. The Draft 2023 Call Letter also includes important announcements and reminders for the 2023 ratings year.

State-based Marketplaces (SBMs) and State-based Marketplaces on the Federal Platform (SBM-FPs) comments on the Draft 2023 Call Letter are valuable. CMS reviews and considers all public comments to determine final decisions on proposed and future refinements to the Draft 2023 Call Letter.

SBMs and SBM-FPs are encouraged to submit comments by the close of the comment period (March 22, 2023) to Marketplace_Quality@cms.hhs.gov copying their Center for Consumer Information and Insurance Oversight (CCIIO) State Marketplace and Insurance Programs Group (SMIPG) State Officer, referencing “Marketplace Quality Initiatives (MQI)-Draft 2023 QRS Call Letter” in the subject line.

Call for Nominations for the QRS/Quality Improvement Strategy Technical Expert Panel

Section 1311(c)(3) of the Patient Protection and Affordable Care Act (PPACA) directs the U.S. Department of Health & Human Services (HHS) Secretary to develop a system that rates QHPs based on relative quality and price. It also requires all Marketplaces to display QHP quality ratings on their websites to assist in consumer selection of QHPs. Based on this authority, CMS established standards and requirements related to QHP issuer data collection and public reporting of quality rating information in every Marketplace.

Nominations are open to new members for a joint QRS and Quality Improvement Strategy (QIS) Technical Expert Panel (TEP). The QRS/QIS TEP is seeking individuals with differing perspectives and areas of expertise to advise on the continued implementation and refinement of the QRS and QIS by providing input on topics such as consumer priorities, updates to the QRS methodology, refinements to the QRS measure set, and discussion of quality improvement strategies. Individuals from SBMs and SBM-FPs have participated in similar TEPs in previous years.

Applicants interested in participating in this QRS/QIS TEP should submit their application and copy their CCIIO SMIPG State Officer and the SMIPG QRS/QIS point of contact (Emmanuelle.vasilak@cms.hhs.gov). Applicants should submit their nomination form by 5 p.m. Eastern Time (ET) on March 1, 2023.

For more information on this opportunity and to obtain the nomination materials, please visit the CMS Measures Management System (MMS) hub: https://mmshub.cms.gov/get-involved/technical-expert-panel/current.

This newsletter is published by the Center for Consumer Information and Insurance Oversight (CCIIO) State Marketplace and Insurance Programs Group (SMIPG).

This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.

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