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|CMS Proposes Improvements for the 2017 Marketplace|
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
Nov. 20, 2015
A press release issued by CMS: "To protect consumer access to health care providers and delivery organizations, the proposal asks states to establish a provider network adequacy standard for health plans in the federal Marketplace.... CMS is proposing to give issuers the choice of offering plans with standardized options such as cost-sharing.... CMS is seeking comment on a requirement that health plans in the federal Marketplace count certain out-of-pocket expenses on unexpected out-of-network services towards a policy holder's annual out-of-pocket maximum, if the service was performed at an in-network facility and advance notice was not provided.... The proposed rule would also increase options for employees in the federal Small Business Health Options Program (SHOP) for plan years beginning in 2017 and beyond."
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