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UPDATE: State-based exchange (SBE) issuers have an extension until March 3 to submit their SBE issuer survey data.

In January, the Centers for Medicare and Medicaid Services (CMS) issued a final regulation for CY 2022 Medicare and Medicaid Programs, which covers a variety of policies in these programs. One noteworthy item is a finalized amendment to 42 CFR § 422.220, which will allow Medicare Advantage (MA) supplemental benefits to reimburse providers that have opted out of Medicare.

On Jan. 28, President Biden signed “Executive Order on Strengthening Medicaid and the Affordable Care Act,” an executive order that will re-open federal exchanges for open enrollment from Feb. 15 to May 15

Several bills seeking to establish requirements that dental plans publicly report loss ratios have been introduced, or are pending introduction, this legislative session.

Following the adoption of the Transparency in Dental Benefits Contracting Model Act (“Model Act”) by the National Council of Insurance Legislators (NCOIL) in December 2020, NADP has seen the introduction of numerous dental network leasing bills in the states (Texas, Idaho, Utah, Kansas, South Dakota, etc).

HB 5160 was introduced in Rhode Island at the end of January. The bill model would modify the state’s existing non-covered services (NCS) law by changing the definition of covered services to include only those services that are actually reimbursed, as opposed to those that are reimbursable.

On Thursday, March 25, Dr. Vivek Murthy was sworn in as the 21st Surgeon General of the United States. Dr. Murthy previously served as the 19th Surgeon General from 2014 to 2017.

North Dakota HB 1154 was signed into law on March 25. The law, which addresses network leasing, prior authorizations and overpayment recovery was significantly modified during negotiations by lead by NADP and its industry partners.

NADP secured several favorable changes to Texas HB 1934, a network leasing and overpayment recovery bill. In addition to ensuring that carriers would be able to provide notices to providers electronically, language pertaining to leasing opt-out and notification requirements during the contract renewal process was removed.

On Jan. 14, the Centers for Medicare and Medicaid Services (CMS) finalized the “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2022; Updates to State Innovation Waiver (Section 1332 Waiver) Implementing Regulations” (CMS-9914-F).