CMS releases payment notice for 2022 coverage year: 5 things to know

Morgan Haefner - Print  | 

CMS released a final rule for states, health insurance exchanges and insurers in the individual and small group markets Jan. 14.

Five things to know:

1. In its Notice of Benefit and Payment Parameters for 2022, CMS finalized a user fee rate of 2.25 percent of premiums for insurers who offer plans through a federally facilitated exchange. Insurers who offer plans through a state-based exchange on the federal platform will see a user fee of 1.75 percent. The rates are down three-quarters of a percentage point from the 2021 fees.

2. The rule allows states to directly enroll eligible Americans into health insurance plans in the individual marketplace. State exchanges that are approved to use direct enrollment are required to have at least one partner that can display and allow for enrollment in qualified health plans. State exchanges can begin using direct enrollment at the beginning of the 2022 plan year, while those linked with the federal government can roll it out in the 2023 plan year.

3. The rule also addresses modifications to Section 1332 waiver applications and network adequacy. 

4. CMS hopes the rule will lower premiums, improve member experience and reduce regulatory burden.

5. CMS said it plans to issue more rules to address things that were in the proposed Notice of Benefit and Payment Parameters but not included in the final rule. 

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