CMS issues proposed notice of benefit and payment parameters for 2026

The Centers for Medicare & Medicaid Services Oct. 4 released its proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees, for 2026. The proposed rule would enhance CMS' authority to address and curtail bad behavior by agents and brokers, such as fraudulent changes to an enrollee's health care coverage. The proposed rule also includes updates to the risk adjustment program, medical loss ratio calculations, and essential community provider certification review process, among other changes. Notably, CMS proposed several updates that would help enrollees understand their costs and maintain coverage, such as updates to the standardized plan options and a new enrollee notification process around tax filing and advanced premium tax credits.