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Proposed Rule from HHS Changes Standards for ACA Individual and Small Group Marketplaces by Neil Krugman on the Waller Healthcare Blog 

by Neil B. Krugman

Published: February, 2017

Submission: March, 2017


In one of the first concrete developments related to Affordable Care Act (ACA) changes following Dr. Thomas E. Price’s approval as Secretary of the Department of Health and Human Services (HHS), a Notice of Proposed Rule making was released by HHS on February 15, 2017, with the stated goal of helping to stabilize the individual and small group marketplaces established by the ACA.

The proposed rule would amend standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year. The proposed rule would also modify standards related to network adequacy and essential community providers for qualified health plans (QHPs) (i.e., plans that are certified as meeting the ACA’s requirements and are allowed to participate in the marketplaces); and the rules around actuarial value requirements. 

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