Health Affairs February 4, 2025
On January 13, 2025, the Centers for Medicare & Medicaid Services (CMS) released its final Notice of Benefit & Payment Parameters (NBPP) for plan year 2026. This annual regulation, referred to informally as the “Payment Rule” or “Payment Notice,” prescribes standards and rules that govern insurers and health insurance Marketplaces under the Patient Protection & Affordable Care Act (ACA). The regulation, the last Payment Rule issued by the Biden administration, went into effect on January 15, 2025.
In addition to the final Payment Notice, CMS released a fact sheet and a final 2026 Letter to Issuers.
The 2026 Payment Notice represents a final set of Marketplace and health insurance policies from the Biden administration. The administration describes its goals with...
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