Updating Payment Parameters, Waiver Implementing Regulations, and Improving Health Insurance Markets Final Rule Summary

On September 27, 2021, CMS of the Department of Health and Human Services and the Department of the Treasury published in the Federal Register a final rule setting certain payment parameters and making changes applicable to the 2022 plan year and beyond. The Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond (86 FR 53412) revises user fees for Federally-Facilitated Exchanges and State Based Exchanges on the Federal Platform for the 2022 benefit year, eliminates the Exchange Direct Enrollment option; and extends the Exchange open enrollment period for an additional month. It finalizes a number of changes relating to section 1332 waivers including repeal of interpretations from 2018 Guidance and provides additional guidance related to waiver applications, amendments, extensions and pass-through funding. It finalizes proposals to eliminate certain separate billing and segregation of funds requirements for the coverage of abortion services; and makes a number of changes including those related to special enrollment periods and Navigator responsibilities. The provisions become effective on November 26, 2021, although most of the provisions are applicable beginning for the 2022 plan year.