Health Policy News November 2024 

Health Policy News is out early this month as we look forward to the holiday next week. This month we start with an overview of proposed annual changes to Exchange regulations and guidance released this fall. Also this month, we share information about new federal grant funding awarded to select states to support insurance department initiatives to promote women’s health. We also continue to feature conferences that our staff has attended with an article highlighting key takeaways from the National Association of Medicaid Directors Conference and the American Public Health Association Annual Meeting and Expo. Finally, we share information about an upcoming webinar – Part 2 of our series on the HCBS Access and Quality Rule.  We wish you all a restful and meaningful Thanksgiving holiday! 

Upcoming Webinar: Unlocking HCBS Payment Adequacy: Spotlight on State Insights & Collaborative Solutions – December 4th! 

Join Public Consulting Group (PCG) Home and Community-Based Services (HCBS) subject matter experts for Part 2 of our webinar series on the CMS Access Final Rule (2442)! Get ready for an engaging session where we’ll focus on the HCBS Payment Adequacy Provisions. Here’s what to expect:   

Unscramble the Details: Dive into the Minimum Performance Requirement and its built-in flexibilities.  

Peek Inside States’ Approaches: Learn what other states have done and explore CMS-cited state examples for implementing requirements similar to the 80% HCBS payment adequacy provision.  

Workshop Solutions: An opportunity to bring your unique challenges to the table, share insights with peers, and brainstorm solutions to navigate the HCBS Payment Adequacy Provisions together.   

Don’t miss this opportunity to engage, learn, and brainstorm with your fellow state colleagues and experts in this space! Please see below for details and registration.    DATE: December 4, 2024     TIME: 11:00 AM EST 

Register Here! 

State Departments of Insurance Release Plans to Advance Access to Women’s Health Services 

Following up on its Expanding Access to Women’s Health Grant Program awards to Departments of Insurance in 14 states and the District of Columbia, the Centers for Medicare & Medicaid Services (CMS) recently shared information about awardee state plans for funded initiatives.  The grants support Departments of Insurance efforts to promote market reforms and consumer protections related to women’s health, with a specific focus on “state efforts to enhance and expand coverage of, and access to, reproductive health and maternal care”. The grant funds can be used for planning and implementation related to specific market reforms and consumer protections, including: 

• • Reviewing and updating state Essential Health Benefit (EHB) benchmark plan selections; 
  • Collecting public input regarding the current state EHB benchmark plan; 
  • Enhancing plan certification and market conduct review tools; and   
  • Outreach and education campaigns. 

For more information about the grant program and state plans, click here. 

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CMS Releases Proposed Exchange Guidance for 2026 

The Centers for Medicare and Medicaid Services (CMS) released its annual proposed guidance for Exchanges and Qualified Health Plans (QHPs) earlier than typical this year. As in prior years, the annual guidance includes the Proposed Notice for Benefit and Payment  Parameters for 2026 (NBPP) and the Draft Letter to Issuers on the Federally-facilitated Exchanges for 2026 (Letter), and addresses QHP certification standards, financial parameters, operational and technical guidance for Exchanges, QHPs, and premium stabilization programs, as well as standards for agents and brokers.    

As we do each year, our subject-matter experts have compiled an overview of key changes outlined in the proposed NBPP and Letter to assist states as you prepare for the 2026 certification process. Click here to read more about the proposed guidance.

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November Conference Round Up 

PCG staff shares insights from additional conferences in another round up this month. This year’s National Association of Medicaid Directors theme was “1-5” and highlighting the impact Medicaid has, and the breath of services that are provided to recipients-including continued innovation on ways to improve care delivery and the quality of care provided. Members of PCG’s Health team were able to connect with clients and learn from other states on best practices, lessons learned and what’s next for Medicaid.] PCG staff also attended the American Public Health Association (APHA) Annual Meeting and Expo in October in Minneapolis, Minnesota. The conference’s theme was “Rebuilding Trust in Public Health and Science,” focusing on strengthening public confidence in health initiatives and research. To read more about these conferences,  click here.

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