Qualified Health Plan Access Surveys: Were Your Results Actionable—and Did the Timeframe Affect Compliance with CMS and State Requirements?

On June 19, 2025   /   Access & Availability, Provider Network Management  
Qualified Health Plan Access Surveys: Were Your Results Actionable—and Did the Timeframe Affect Compliance with CMS and State Requirements?

In the 2025 Final Rule, CMS released its expectations and reporting requirements to ensure timely access to care. By the second Friday in June each year, issuers that offer Qualified Health Plans (QHPs)—including stand-alone dental plans—in the federally-facilitated exchanges or the federally-facilitated Small Business Health Options Programs

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Qualified Health Plans Secret Shopper Requirements: Do You Have a Process to Survey Your Network and Capture Actionable Analytics by May 31?

On January 21, 2025   /   Access & Availability, Provider Network Management  
Qualified Health Plans Secret Shopper Requirements: Do You Have a Process to Survey Your Network and Capture Actionable Analytics by May 31?

Are You Meeting CMS and State Access-to-Care Requirements? In the 2025 Final Rule, CMS released its expectations and reporting requirements to ensure timely access to care. Effective January 1, 2025, CMS requires issuers that offer Qualified Health Plans (QHPs), including stand-alone dental plans, to take specific actions.

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