The final rule from the Centers for Medicare & Medicaid Services sets standards for Marketplaces and issuers, as well as requirements for agents, brokers, web-brokers, direct enrollment entities, and assisters that help Marketplace consumers. The rule includes policies that extend the special enrollment period for low-income people to enroll in coverage in any month rather than only during Open Enrollment, provides states the ability to increase access to routine adult dental services such as cleanings, diagnostic X-rays, and restorative services like fillings and root canals, and sets network adequacy standards for the time and distance people travel to appointments with in-network providers. The rule standardizes certain operations across the Marketplaces to increase reliability and consistency for consumers. Lastly, the rule includes several policies impacting the Medicaid program, Children’s Health Insurance Program, and the Basic Health Program.
