CMS Releases Notice of Benefit and Payment Parameters and MA Rates for 2022

On January 14, the Centers for Medicare and Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters for 2022. This included a finalized user fee of 2.25% of premiums for insurers on the federally facilitated exchange. The rule also allows states to enroll eligible patients in the individual marketplace.

Insurers who offer plans through the state-based exchanges on the federal platform will see a user fee of 1.75%. According to Becker’s Hospital Review, these are down three-quarters of a percent from the 2021 fees.

For state exchanges, the rule allows states to directly enroll Americans into health insurance plans in the individual marketplace. Those that are approved to use direct enrollment must have one partner that can allow for enrollment in qualified plans. States may begin using direct enrollment at the end of 2022.

CMS also estimates that Medicare Advantage (MA) plans will get more than 4% in 2022 than they will this year, an increase of 1.25%, Inside Health Policy reports. However, CMS did not finalize star ratings for COVID-19 vaccination rates because stakeholders believed that such a move would be too complicated. 

CMS also said in the notice that after receiving comments on the advanced rate notice measures to decrease the impact of the pandemic on MA risk scores and medical loss ratio calculations, the agency is continuing to communicate with stakeholders about the development of future guidance.

Part D Payment Modernization Model Calendar Year (CY) 2022 Fact Sheet