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). The Administration continues to review other parts of the rule for “finalization at a later date.” Notably, language that would have allowed the sale of non-exchange standalone dental plans (SADPs) alongside exchange SADPs on direct enrollment platforms was not included in this final rule. NADP advocated against the inclusion of this language on grounds that it would cause consumer confusion if dental plans met the pediatric dental essential health benefit requirements or were eligible for subsidies. It is unclear if CMS intends to finalize the remainder of the rule before the regulatory freeze President-elect Biden is anticipated to enact upon his inauguration on Jan. 20.

The final rule would create an Enhanced Direct Enrollment (E-DE) option for states to end the use of a central state or federal exchange, instead leaving consumer facing websites to brokers and plans through a process known as direct enrollment. The federal government would still conduct subsidy and eligibility checks for the platforms. NADP opposed the E-DE method out of concern for the potential loss of coverage through the end of automatic renewal for exchange plans and consumer confusion about E-DE platforms.

Additionally, the final rule would codify sub-regulatory guidance from CMS on 1332 waivers, allowing states additional flexibility on enrollment preservation requirements for waivers. The rule also decreases exchange user fees by .75%.

NADP will continue to monitor CMS activity for another final rule. Please contact Sr. Government Affairs Analyst Owen Urech.



Full Final Rule Text

CMS Press Release

NADP Comments on Proposed Rule

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