– Expect comments to be due early April. The Centers for Medicare & Medicaid Services (CMS) released the “Marketplace Integrity and Affordability Proposed Rule,” which proposes additional safeguards to protect consumers from improper enrollments and changes to their health care coverage, as well as establish standards to ensure the integrity of the Affordable Care Act (ACA) Marketplaces. Key proposals include revising standards for income verification processes; modifying eligibility redetermination procedures; revising actuarial value standards for health plans; requiring Marketplaces to deny eligibility for advance payments of the premium tax credit (APTC) upon a tax filer’s failure to reconcile APTC for one year; shortening the annual Open Enrollment Period to November 1 through December 15; and eliminating the special enrollment period for persons with annual household incomes below 150% of the federal poverty level (FPL). Since 2018, the number of Marketplace plans in rural areas has grown, although the number of issuers in rural areas still lags behind the number in urban areas. Once CMS displays the proposed rule in the public Inspection section of the Federal Register, the public will have 30 days to submit comments.
