The Department of Health and Human Services today issued proposed rules for the health insurance marketplaces for plan year 2019. HHS proposes a number of policy changes for both the individual market and the Small Business Health Options Program. The proposed changes include providing states with additional flexibility to define the essential health benefits to, among other things, increase the affordability of health plans; modifying the availability of special enrollment periods; refining further the risk adjustment model; and expanding the types of entities that may be navigators, among other changes to the program. Comments on the proposed rule are due Nov. 27.

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An AHA blog published July 28 highlights new electronic prior authorization requirements that begin Jan. 1, 2027, as a result of the Centers for Medicare…
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