Quick Read on QHP Certification

New Network Adequacy Rules for the Federally-Facilitated Exchange

Meet CMS requirements for provider networks, Appointment Wait Times and Telehealth

Health plans, benefits managers and brokers that have members and beneficiaries in the Federally-facilitated Exchanges (FFEs) should take note of the changes to network adequacy standards which include new rules for Essential Community Providers (ECPs), Telehealth Services and Appointment Wait Times. In particular, requirements that apply to Plan Year 2023 data submissions, which will set the stage for Plan Year 2024 certification applications, include:

  • Changes to the network adequacy standards for time, distance and provider specialty types
  • Essential Community Providers (ECPs) and Telehealth Services
  • Planning for incorporating Appointment Wait Times in Plan Year 2024

Download our executive summary to get a quick overview of the changes and to learn how Quest Analytics helps you meet these changes with our pre-built template.

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