Updated to include the additional Network Adequacy and Provider Validation Requirements announced by CMS in May 2025.

Policy Brief on the Final HHS Notice of Benefit and Payment Parameters for 2026

Discover the latest Network Adequacy and Provider Directory Accuracy Requirements for Health Issuers on the Federal and State Exchanges

What's Inside the Policy Brief

Updates for the Federally-facilitated Exchanges

• New Network Adequacy Geographic Distance Methodology
• Alternative Time and Distance Standards Introduced
• Three Additional Provider Specialty Types Added to the Network Adequacy Template
• New & Updated Provider Validations
• Provider Directory Accuracy Requirements
• Key QHP Application Dates for Data Submission and Certification

Updates for the State-based Exchanges and State-based Exchanges on the Federal Platform (SBE-FPs)

• Key Changes to State Requirements for Network Adequacy and QHP Certification

Download Our Policy Brief Now

Download our policy brief to stay informed and prepared for the latest Network Adequacy Standards and Provider Directory Accuracy Requirements.

Quest Enterprise Services® (QES®) for QHP Certification

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