Health Policy News May 2023

Happy Spring from the Health Policy News Team!

This month we have several regulatory updates, with an overview of the final Notice of Benefit and Payment Parameters/Annual Letter to Issuers in the Federally-facilitated Exchanges, as well as a summary of the new guidance for states on the Medicaid Reentry 1115 Demonstration Waiver opportunity.

Lastly, PCG will be hosting a webinar on June 15th related to the release of two Center for Medicare and Medicaid Services (CMS) proposed rules, Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM).

Please plan to join us on June 15, 2023, from 2-3 pm eastern time when we will have subject matter experts on-hand to field questions about how these proposed changes may affect your state Medicaid program. Additionally, we will be highlighting areas where CMS has specifically requested state feedback to assist you in providing comments to CMS by the July 3rd deadline.  

To see the full details about the webinar and register, click here

2024 Final Marketplace Rules & Guidance for Health Issuers 

On April 17,2023, the Department of Health and Human Services (HHS) released the final Notice of Benefit and Payment Parameters for 2024 (NBPP), and, on May 1, 2023, the final 2024 Letter to Issuers in the Federally-facilitated Exchanges (Letter). Most of this year’s final changes are more adjustments than the major overhauls we have seen in recent prior years, with more significant policy changes focused on network adequacy and essential community provider standards and categories.  

To review our annual finalized overview of the significant policy changes from previous years’ guidance, click here 

HHS released new Medicaid Reentry Section 1115 Demonstration Guidance for States   

In April the Health and Human Services released new and anticipated guidance for those exiting the prison system. The guidance encourages / allows states to cover a package of pre-release services for up to 90 days prior to the individual’s expected release date that could not otherwise be covered by Medicaid. The services included address various health concerns, including substance use disorders and other chronic health conditions. 

To read more about the guidance and how states are utilizing it today, click here.


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