HHS Releases 2026 Notice of Benefit and Payment Parameters Final Rule

February 11, 2025

EGWP marketplace medicaid Medicare

On Jan. 13, HHS issued the final Notice of Benefit and Payment Parameters for 2026 (NBPP). HHS states the rule finalizes safeguards to protect consumers from unauthorized changes to their coverage, measures to ensure the integrity of federally run marketplaces, and provisions to make it easier for consumers to understand costs and enroll in coverage. The rule additionally updates the HHS-operated risk adjustment program, 2026 user fee rates for insurance issuers, changes to calculations for the Basic Health Program, and annual reporting of information from the ACA Quality Improvement Strategy.

legislation

CMS Releases the CY2026 Advance Rate Notice and Draft Part D Program Instructions

On Jan. 10, CMS released the Calendar Year (CY) 2026 Medicare Advantage and Part D Advance Notice which includes methodological and payment policy changes for the programs in 2026. The Advance Notice also includes draft program instructions for CY 2026 for the Medicare Part D program under the redesigned Part D benefit as required by […]
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February 11, 2025

EGWP Medicare

legislation

HHS Proposes Changes to HIPAA Security Rule

On Dec. 27, HHS issued a proposed rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule to require health plans, health care clearinghouses, most health care providers, and their business associates, to strengthen cybersecurity protections for individuals’ electronic protected health information (ePHI).  The proposals would address: changes in the […]
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February 11, 2025

EGWP marketplace medicaid Medicare

legislation

HHS Withdraws Proposed Rule Expanding Coverage of OTC Preventive Products; SCOTUS Agrees to Hear ACA Case

On Jan. 13, HHS withdrew a proposed rule intended to expand coverage of recommended preventive services without cost-sharing in commercial employer and individual plans, with a particular focus on reducing barriers to coverage of contraceptive services by prohibiting prescription requirements for over-the-counter contraceptives. Last month, the Departments also withdrew a proposed rule intended to expand […]
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February 11, 2025

EGWP marketplace medicaid Medicare

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