CCIIO Finalizes Blueprint for Health Insurance Exchanges

Author: Tom Entrikin | Posted: 17. August 2012 09:20

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The Center for Consumer Information and Insurance Oversight (CCIIO) released on August 14 its final ?Blueprint for Approval of Affordable State-based and State Partnership Exchanges? under Title I of the Affordable Care Act (ACA).??? The ?blueprint? requires applications from States electing to fully operate Exchanges as well as States electing to perform selected exchange functions in partnership with a ?Federally-facilitated Exchange (FFE).?? ?

One FFE partnership option under the ?blueprint? enables States to take the lead role in health plan management activities such as certification, recertification, and decertification of qualified health plans (QHPs); collection and analysis of data on QHPs; and QHP monitoring and oversight.?? Another FFE partnership option enables States to take the lead role in consumer assistance activities such as overseeing in-person consumer assistance, managing the Navigator program (under which direct assistance will be provided to help consumers sign up for health coverage), and other public outreach and education activities.? States can elect either or both options.

The final ?blueprint? differs from an earlier draft issued on May 16 in that it provides for a new in-person assistance option, distinct from Navigators, which will be useful especially in the Exchanges? initial open enrollment period.?? Exchanges will begin taking applications from consumers on October 1, 2013 for coverage available on January 1, 2014.? The new option will be eligible for funding under Exchange Establishment grants.

The final ?blueprint? requires States to submit applications, declarations of intent from the Governor, and legal certifications to CCIIO by November 16, 2012 to secure conditional approval in January 2013 for Exchange functions related to coverage available in January 2014. ?States that do not elect to participate in 2014 may elect to participate in 2015.? States may also elect in any case to make Medicaid eligibility determinations under the ACA, collaborate with FFEs in activities such as data exchanges and reviews of QHPs, and operate their own reinsurance programs under the ACA.

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Source: http://www.publicconsultinggroup.com/HHSNews/post/CCIIO-Finalizes-Blueprint-for-Health-Insurance-Exchanges.aspx

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