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Yesterday, the Biden-Harris Administration, through the Centers for Medicare & Medicaid Services (CMS), announced measures that will make coverage more accessible, expand behavioral health care access, simplify choice, and make it easier for millions of Americans to select a health plan in 2024.
“The Biden-Harris Administration has worked tirelessly to expand access to health insurance and lower health care costs for America’s families,” said HHS Secretary Xavier Becerra. “Today’s announcement of the 2024 Notice of Benefit and Payment Parameters Final Rule is a step forward toward creating a health care system which prioritizes equity, access, and affordability. HHS remains committed to removing barriers to care to ensure quality health care is within reach for everyone who needs it.”
The 2024 Notice of Benefit and Payment Parameters Final Rule (final 2024 Payment Notice) finalizes standards for issuers and Marketplaces, as well as requirements for agents, brokers, web-brokers, and Assisters that help consumers with enrollment through Marketplaces that use the federal platform. These changes further the Biden-Harris Administration’s goals of advancing health equity by addressing the health disparities that underlie our health system, such as strengthening network adequacy standards and creating a new special enrollment period (SEP) for those who lose Medicaid or Children’s Health Insurance Plan (CHIP) coverage, among others. The rule also builds on the Affordable Care Act by expanding access to quality, affordable health coverage and care, especially behavioral health care, and making it easier to select and enroll in health coverage.
Major provisions related to agents and brokers include:
- Additional time to review evidence submitted by agents, brokers, or web-brokers to rebut allegations that led to suspension of their Marketplace agreement(s) or to request reconsideration of termination of their Marketplace agreement(s)
- Requiring that agents, brokers, and web-brokers document that eligibility application information has been reviewed by and confirmed to be accurate by the consumer or the consumer’s authorized representative prior to application submission
- Requiring that agents, brokers, or web-brokers document the receipt of consent from the consumer or the consumer’s authorized representative prior to providing assistance
For more information, view the full press release below.
Additional resources:
CMS also released the 2024 Final Actuarial Value (AV) Calculator and Methodology.
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