Administration Expanding Access to Healthcare in 2024

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Administration Expanding Access to Healthcare in
2024
Strengthening Affordable Care Act
(ACA) Recently, the Biden-Harris Administration
released the 2024 Notice of Benefit and Payment
Parameters Proposed Rule that aims to further
advance the Administrations efforts to build on
the Affordable Care Acts (ACA) efforts to
provide and expand access to quality healthcare
options for millions of consumers. This proposed
rule would increase access to health care
services, simplify choice and improve the plan
selection process, and make it easier to enroll
in coverage. The current administration has taken
historic action to expand access to health care,
and the Affordable Care Act Marketplace provides
millions of Americans vital coverage. Lets see
how the administration is expanding access to
healthcare in 2024. Expanding Access to
Behavioral Health The current administration has
made expanding access to behavioral health care a
top priority. As part of that effort, the
proposed rule includes two new major essential
community provider (ECP) categories that are
critical to delivering needed behavioral health
care Substance Use Disorder Treatment Centers
and Mental Health Facilities. The rule also
furthers access to providers by including a
proposal to extend the current overall 35 percent
provider participation threshold to two major ECP
categories Federally Qualified Health Centers
and Family Planning Providers.
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Administration Expanding Access to Healthcare in
2024
These changes, in conjunction with a proposal to
expand Network Adequacy requirements, would
increase provider choice, advance health equity,
and expand access to care for consumers who have
low income, complex or chronic healthcare
conditions, or who reside in underserved areas,
as these consumers are often disproportionately
affected by unanticipated costs associated with
provider network status and limited access to
providers. Improving Health Plan Selection
Process The rule includes proposals to make it
easier for consumers to pick a health plan that
best fits their needs and budget by updating
designs for standardized plan options and
limiting the number of non-standardized plan
options offered by issuers of qualified health
plans (QHPs) through the Federally-facilitated
Marketplaces (FFMs) and State-based Marketplaces
on the Federal Platform (SBM-FPs). The average
number of plans available to consumers on the
Marketplace has increased from 25.9 in PY2019 to
113.6 in PY2023. Having too many plans to choose
from can limit consumers ability to make a
meaningful selection when comparing plan
offerings. Streamlining the plan selection
process would make it easier for consumers to
evaluate plan choices available on the
Marketplaces and to select a health plan that
best fits their unique health needs.
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Administration Expanding Access to Healthcare in
2024
Ease of Enrollment The proposed rule would give
the Marketplaces the option to implement a new
rule for the special enrollment period for people
losing Medicaid or Childrens Health Insurance
Program (CHIP) coverage. This option would mean
that consumers would have 60 days before, or 90
days after, their loss of Medicaid or CHIP
coverage to select a Marketplace plan. The
administration believes that this new proposed
special rule would help mitigate coverage gaps
when consumers lose Medicaid or CHIP while
allowing for a more seamless transition into
Marketplace coverage. The proposed rule also
changes the current coverage effective date
requirements so that Marketplaces have the option
to offer earlier coverage effective start dates
for consumers attesting to a future coverage
loss. CMS believes that these changes would
ensure qualifying individuals are able to
seamlessly transition from other forms of
coverage to Marketplace coverage as quickly as
possible with no coverage gaps. The proposed
rule will now allow assisters to conduct
door-to-door enrollment to increase consumer
engagement and advance health equity. Assisters
currently conduct door-to-door outreach,
education, and schedule follow-up appointments,
but are prohibited from providing enrollment
assistance upon an initial interaction at the
consumers residence. Removing this prohibition
will make it easier for consumers to get help
when enrolling into coverage.
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Administration Expanding Access to Healthcare in
2024
Under current re-enrollment processes, enrollees
who are eligible for lower-priced health plans
could be automatically re-enrolled in a more
costly QHP. This rule includes a proposal that
would ensure these consumers are automatically
enrolled into their same plans or lower-cost,
more generous plans when available, lowering
their healthcare costs by taking advantage of
these savings. Medical Billers and Coders
(MBC) is a leading medical billing company
providing complete medical billing and coding
services. We shared a recent announcement for
provider education purposes, you can refer CMS
link for a detailed understanding. If you are a
practice owner and feel the billing and coding
operations are pulling you back then we can
assist you. Our medical specialty-wise billing
and coding services will help you to receive
timely and accurate insurance reimbursements. To
know more about our billing and coding services,
call us at 888-357-3226 or email us
at info_at_medicalbillersandcoders.com Reference H
HS Releases Policies to Make Coverage More
Accessible and Expand Behavioral Health Care
Access for Millions of Americans in 2024