The Centers for Medicare & Medicaid Services Oct. 4 released its proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees, for 2026. The proposed rule would enhance CMS' authority to address and curtail bad behavior by agents and brokers, such as fraudulent changes to an enrollee's health care coverage. The proposed rule also includes updates to the risk adjustment program, medical loss ratio calculations, and essential community provider certification review process, among other changes. Notably, CMS proposed several updates that would help enrollees understand their costs and maintain coverage, such as updates to the standardized plan options and a new enrollee notification process around tax filing and advanced premium tax credits.

Perspective
Public
Healthcare affordability remains one of the top concerns for Americans. A Morning Consult poll of 2,000 voters released this week by the Coalition to…
Headline
The AHA filed an amicus brief June 5 in the U.S. District Court for the Eastern District of Pennsylvania in support of a provider seeking to obtain…
Headline
The Centers for Medicare & Medicaid Services has released an updated report on complaint data and enforcement of health insurance market reforms. CMS said…
Headline
A survey released June 4 by the Commonwealth Fund on insurance coverage denials found that 1 in 5 privately insured U.S. adults reported that they or a family…
Headline
The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital…
Headline
A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels…