CMS issues RFI on brokers and agents for FFEs
Posted on February 11, 2013 | Comment (1)
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The Centers for Medicare & Medicaid Services (CMS) issued a proposal to collect data on licenses and other information to register and monitor health insurance brokers and agents for the federal health insurance exchange. Health insurance brokers and agents would enter basic identifying information on the exchange portal during initial registration and when registration is complete, brokers and agents would be routed to CMS’s Learning Management System to complete required training and exams. CMS would use broker and agent usernames and ZIP codes to record training history and to communicate the results with the federally facilitated exchange (FFE). Under the Affordable Care Act (ACA), open enrollment in all exchanges begins Oct. 1 for plans that take effect in 2014.
Comments on the proposal are due April 8.
Comment (1)
May 9, 2013
Today the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) announced the awarding of $150 million in funding to the nation's 1200 community health centers for the purposes of providing in-person enrollment assistance under the Affordable Care Act (ACA). With these new funds, health centers will be able to hire new staff, train existing staff, and conduct community outreach events and other educational activities in order to help provide in-person enrollment assistance to uninsured individuals across the country, according to the agency press release here. The full funding announcement, which contains detailed breakouts of the dollar amounts awarded to specific health centers, can be found here.
May 2, 2013
The Center for Consumer Information and Insurance Oversight (CCIIO) released new guidance detailing the roles of agents, brokers and web-brokers in the health insurance Exchanges. The letter claims that State-Based Exchanges may establish their own regulations on the amount insurers can pay brokers, while Federally-Facilitated Exchanges, which also includes State-Partnership Exchanges, will not create commission schedules or pay commission directly to the brokers. CCIIO also purported that they will re-evaluate the requirement that brokers receive the same compensation for selling plans outside of the Exchanges as they would for selling qualified health plans (QHP). Brokers are anticipated to play a role in educating consumers entering into the Exchange, and the Centers for Medicare and Medicaid Services (CMS) will be responsible for registering and training agents and brokers to help consumers in the QHP selection process. States, however, will retain the authority to license and regulate brokers and agents.
February 1, 2013
On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued an omnibus Final Rule, which modifies the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules, as required by the Health Information Technology for Economic and Clinical Health Act (HITECH). It also includes changes to the Privacy Rule requires by the Genetic Information Nondiscrimination Act (GINA).
The team at Health Information & the Law has written a detailed overview of the Final Rule, which highlights the key changes to the Privacy, Security, Enforcement, and Breach Notification Rules. A longer, more comprehensive analysis piece along with a comparative table of changes included in the Final Rule is forthcoming at their website, HealthInfoLaw.org.
January 18, 2013
The U.S. Department of Health and Human Services (HHS) issued a 563-page omnibus rule yesterday afternoon. The rule updates the Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations, as required under the American Recovery and Reinvestment Act of 2009. Notably, the rule expands direct liability for breaches to contractors, subcontractors and other associates of healthcare providers, plans and insurers. In addition, the rule outlines noncompliance penalties, which vary depending on level of negligence and are capped at $1.5 million. The rule also expands patient rights, such as improving electronic medical record access and enabling patients to limit disclosure of out-of-pocket payments for treatments. HIPAA-covered entities and business associates must by in compliance with the new regulations by September 23 of this year.
The final rule will be published in the January 25 Federal Register.
July 8, 2011
The U.S. Department of Health and Human Services has issued an Interim Final Rule (IFR) on improving the simplicity of electronic claims transactions, which fall under the Health Insurance Portability and Accountability Act (HIPAA). Transaction standards adopted under HIPAA enable electronic data interchange through a common structure, but complex sets of operating rules have made the process cumbersome and expensive. Stemming from the Obama Administration's push to simplify regulations and rulemaking across all federal agencies, this particular IFR seeks to define a single set of operating rules related to electronic claims submission, in order to create uniformity and reduce administrative costs.
February 1, 2013
On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued an omnibus Final Rule, which modifies the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules, as required by the Health Information Technology for Economic and Clinical Health Act (HITECH). It also includes changes to the Privacy Rule requires by the Genetic Information Nondiscrimination Act (GINA).
The team at Health Information & the Law has written a detailed overview of the Final Rule, which highlights the key changes to the Privacy, Security, Enforcement, and Breach Notification Rules. A longer, more comprehensive analysis piece along with a comparative table of changes included in the Final Rule is forthcoming at their website, HealthInfoLaw.org.
February 1, 2013
On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued an omnibus Final Rule, which modifies the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules, as required by the Health Information Technology for Economic and Clinical Health Act (HITECH). It also includes changes to the Privacy Rule requires by the Genetic Information Nondiscrimination Act (GINA).
The team at Health Information & the Law has written a detailed overview of the Final Rule, which highlights the key changes to the Privacy, Security, Enforcement, and Breach Notification Rules. A longer, more comprehensive analysis piece along with a comparative table of changes included in the Final Rule is forthcoming at their website, HealthInfoLaw.org.
September 20, 2012
A new report released by the University of Massachusetts Medical School (UMMS) and the National Academy of Social Insurance (NASI) examines the establishment of the information technology (IT) infrastructure to promote access to and enrollment in health plans through Exchanges and expanded Medicaid programs under the Affordable Care Act (ACA). The report reviews lessons from “Early Innovator” and other advanced states as they prepare for these ACA provisions. The report, entitled "Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act," reviews issues that policymakers should consider as they develop state-based technology infrastructures.
January 9, 2013
Previous implementation briefs have addressed the electronic health record (EHR) incentive programs enacted by the HITECH Act, part of ARRA. These programs financially incentivize adoption of EHR technology that meets standards of interoperability and accessibility, among other criteria, and incentivize providers to use the technology to engage with patients and improve patient care. Among other goals, the EHR incentive program is intended to improve patient...
November 14, 2012
Historically, the American health care system through its siloed delivery and reimbursement models has failed to support a patient-centered and coordinated delivery system. Fragmentation has resulted in a health care system where potentially avoidable hospital readmissions, duplicative testing, and medication errors are common. Widespread adoption and use of Health Information Technology (HIT) has the potential to decrease these occurrences by enabling providers to electronically exchange health information with other providers and their patients across settings of care to better coordinate patient care.
Recognizing the potential benefit of widespread use of HIT, in 2009 Congress authorized...
October 11, 2012
A previous Implementation Brief discussed the electronic health record (EHR) incentive program enacted by the HITECH Act, which is part of ARRA[1]. Stage 1 of that program began in 2011 and the Centers for Medicare and Medicaid Services (CMS) reports that through July 2012, more than $6 billion in Medicare and Medicaid incentive payments had been made to 132,511 physicians and hospitals that demonstrated meaningful use of EHRs[2]. On August 23, 2012, CMS published a final rule on the Stage 2 Meaningful Use criteria that eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) must meet to qualify as meaningful users of electronic health records (EHRs) and receive incentive payments under the Medicare and Medicaid programs[3]. This final rule builds upon the Stage 2 proposed rule, released on March 7, 2012. The Stage 2 final rule also revises certain Stage 1 criteria, which were finalized in the July 28, 2010 final rule[5]. Stage 1 of the incentive program was designed to encourage providers to move key clinical data into an electronic format, and focused on establishing the functionalities of a certified EHR system[6]. With the final rule, CMS continues its incremental approach to continuing this transitional process and strikes a balance between stakeholders calling for Stage 2 to require demonstrated improvements in care as a result of EHR use and those seeking more flexibility in the rules, with incentives simply to acquire EHR technology.
July 9, 2012
On June 22, 2012, the Internal Revenue Service and Treasury Department released for public view a notice of proposed rulemaking (NPRM) regarding the obligations of nonprofit hospitals seeking federal tax-exempt status. The NPRM deals with that portion of the ACA related to the obligation of nonprofit hospitals to maintain financial assistance and emergency medical care policies, as well as certain billing and collection policies, as a condition of federal tax exemption. The NPRM comment period will be for 90 days following Federal Register publication. The agencies have identified...
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Health reform is here and we, agents, need access to registration and training NOW. It is essential that we in the field are educated on the process of enrolling our clients in the proper product that is available AND at the appropriate level of assistance, if any, the insured will receive in subsidy for premiums. We are being bombarded with questions that we can not fully address. Many of our small group clients are considering dropping group coveragee all together effective January 01, 2014. We can’t wait to address this issue. April 8 sounds as if we will not have firm guidance or portal enrollment in FFE until June or July giving us little time to prepare for the enrollment guantlet you are setting us up to run in October.