Federal Policy
CMS Releases 2027 Notice of Benefit and Payment Parameters
The Centers for Medicare & Medicaid Services has released the 2027 Notice of Benefit and Payment Parameters (NBPP). The NBPP sets annual requirements for qualified health plans offered through the ACA marketplaces, including actuarial value standards, cost-sharing limits, and payment methodologies. While the NBPP primarily governs marketplace plans, provisions may affect Medicaid managed care organizations that operate dual marketplace and Medicaid lines of business, particularly regarding quality measurement alignment, rating approaches, and administrative standards. The final rule typically takes effect for the plan year beginning January 1, 2027.
Why it mattersMCOs operating both marketplace and Medicaid plans must assess whether quality reporting, actuarial, or network adequacy provisions in the NBPP create operational or compliance alignment opportunities or conflicts across product lines.