AHA comments on draft guidance for 2017 qualified health plans

The AHA today recommended changes to certain provisions of the Centers for Medicare & Medicaid Services’ 2017 draft letter to issuers of qualified health plans in federally facilitated marketplaces. “While the AHA generally supports the use of time and distance standards for provider networks similar to standards used by the Medicare Advantage program, we encourage CMS to allow for the special circumstances and unique medical needs of children and adults with complex and chronic medical conditions,” wrote Ashley Thompson, AHA senior vice president of public policy analysis and development. AHA also urged CMS to consider including in its analysis of the breadth of a QHP’s network the types of specialists that treat patients with complex medical and chronic conditions. In addition, the association urged CMS to provide flexibility with regard to the timeline for compliance with the QHP patient safety standards, and to require QHPs to accept third-party premium and cost-sharing payments from hospitals, hospital-affiliated foundations and other charitable organizations. The draft letter provides general operational guidance for health plan issuers, including more detail on certain provisions contained in CMS’s proposed rule for 2017 QHPs. AHA commented on the proposed rule last month.