CMS rule proposal another challenge for insures, says Wells Fargo

Wells Fargo says the Centers for Medicare and Medicaid Services issued a proposed rule focused on program integrity on the healthcare exchanges. While the scope of issues is difficult to define, “it is hard to argue against improved oversight,” the analyst tells investors in a research note. The firm now sees another source of risk for exchange plans beyond the enhanced subsidies. The new rule proposes making numerous changes to regulations governing the individual market, including shortening the open enrollment period, ending continuous special enrollment period, identification of conflicts in attested income versus other data sources, and removing Deferred Action for Childhood Arrivals eligibility for coverage, Wells points out. The firm believes these changes, in the short term, will be another challenge for managed care organizations to deal with, in addition to the expiration of enhanced exchange subsidies at the end of 2025. Names in the space include UnitedHealth (UNH), Cigna (CI), Centene (CNC), CVS Health (CVS), Humana (HUM), Moline (MOH), and Elevance Health (ELV).