Acknowledging demands for “transitional relief” as perhaps 4 million individuals are facing health insurance cancellation notices for 2014 and websites for federally-facilitated health insurance Exchanges are not meeting consumers’ expectations, the Center for Consumer Information and Insurance Oversight (CCIIO) has released a letter to state health insurance commissioners stating that health insurance issuers in the individual and small group markets may choose to extend coverage that would otherwise be cancelled due to market reform provisions of the Affordable Care Act (sections 2701-2709 on establishing premiums, comprehensive benefits coverage, guaranteed availability of coverage, coverage of adults with pre-existing conditions, etc.). [More]
The U.S. Department of Health and Human Services published a notice in the Federal Register on November 19, 2013 proposing a quality rating system (QRS) for qualified health plans (QHPs) offered through health insurance Exchanges. The QRS is based on section 1311(c)(3) and (4) of the Affordable Care Act (ACA), which requires HHS to create a system enabling consumers to compare QHPs based on relative quality, price, and enrollee satisfaction. [More]
Boston, MA, November, 2013 – The state of Washington Office of Financial Management (OFM) selected Public Consulting Group (PCG) to help streamline its eligibility business processes. In response to a legislative mandate, the OFM is working to simplify procedures, improve customer service, and reduce state expenditures for its public assistance and medical eligibility programs. [More]
On November 7, 2013, the U.S. Department of Health and Human Services (DHHS) announced the award of $150 million of Affordable Care Act (ACA) funds to new primary care sites in 236 communities across the country. The funds are estimated to help provide care for approximately 1.25 million additional patients. [More]
The U.S. Department of Health and Human Services (HHS) released a report on November 13, 2013 indicating that, during the period October 1 – November 2, a total of 106,185 individuals had selected qualified health plans through health insurance Exchanges; 79,391 of those individuals selected a plan through a State-based Exchange in 15 States, including 35,364 in California alone (the report notes California’s exemplary, multi-lingual public outreach campaign), while only 26,794 did so through Federally-facilitated Exchanges in all other States. [More]
The U.S. Departments of Health and Human Services, Labor, and the Treasury published final rules in the November 13, 2013 Federal Register on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and related provisions of the Affordable Care Act (ACA). [More]
On November 3, 2013, the Burlington Free Press reported that Governor Peter Shumlin invoked a “safety valve” in state law that extends deadlines an additional three months past the end of the year. Because of continuing technical problems with the state-operated health insurance exchange under the Affordable Care Act (ACA), the Governor utilized section 41a of the 2012 state law implementing the ACA, which “will allow individuals who buy their own insurance and small employers to extend their current coverage plans until March 31.”
The Commonwealth Fund released on November 4, 2013 a report entitled “Americans’ Experience in the Health Insurance Marketplaces: Results from the First Month.” The report is based on a tracking survey of adults aged 19-64 conducted October 9-27. The survey found that 60 percent of respondents who were potentially eligible for enrollment in a qualified health plan or expanded Medicaid under the Affordable Care Act knew about their Exchange; 17 percent of respondents had already visited their Exchange (on-line, by phone, by mail, or in person) to shop for a plan; and 21 percent of those visitors (i.e., 3.5 percent of respondents) said they had enrolled in a plan. [More]
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on October 30, 2013 providing further clarification on financial integrity and oversight standards related to health insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges, and on reinsurance and risk adjustment programs under the Affordable Care Act (ACA). This final rule relates to portions of earlier proposed rules that were not finalized or were published as “interim final” pending further consideration of public comments. It addresses adjustments and refunds for consumers in the event of premium and cost-sharing calculation errors by the Exchange, special enrollment periods under the Small Business Health Options Program (SHOP), record maintenance, compliance enforcement procedures, and other clarifications. It will be effective December 30, 2013.
The Centers for Medicare and Medicaid Services (CMS) issued a bulletin on October 28, 2013 confirming that, if an individual enrolls in a qualified health plan (QHP) offered through a health insurance exchange at any time before the end of the initial enrollment period on March 31, 2014, the individual will not be subject to a federal tax penalty in 2015 for coverage gaps in months between January 1, 2014 and the effective date of enrollment in the QHP. The bulletin takes into account “hardship” and “short coverage gap” exceptions to the “individual mandate” under the Affordable Care Act (ACA) but does not suspend the mandate nor extend the initial enrollment period despite widely reported, hopefully correctable difficulties faced by millions of consumers with websites for Federally-facilitated Exchanges.