December 29, 2021
The CMS released its proposed Notice of Benefit and Payment Parameters rule late Tuesday, revealing that payers would have to offer standardized plan options for every product network type, plan tier type, and plan classification. The CMS said the goal is to allow consumers to have an easier shopping experience. In addition, the rule would reestablish mandated network adequacy reviews for plans on the federal exchange and address health equity through several provision: requiring insurers to include 35 percent of essential community providers in each plan’s service area, barring insurers explicitly from discriminating against patients based on sexual orientation or gender identity, and streamlining the essential health benefits non-discrimination policy by requiring insurers to rely on clinical evidence in their plan designs. (Fact sheet here)