Value Based Purchasing and Health Care Reform

HHS & IRS Release Insurance Exchange and Eligibility Proposed Rules

For additional information, see the following links:

Letter from Secretary of Health and Human Services Kathleen Sebelius to State Officials (Healthcare.gov) (8/12/2011)

Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market: Eligibility Determinations; Exchange Standards for Employers - Proposed Rule (as published in the Federal Register 8/17/2011)

Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 - Proposed Rule (as published in the Federal Register 8/17/2011)

Health Insurance Premium Tax Credit - Notice of proposed rulemaking and notice of public hearing (as published in the Federal Register 8/17/2011)

 

HHS Releases CO-OP Proposed Rule

The U.S. Department of Health and Human Services has released a proposed rule that would implement the Consumer Operated and Oriented Plan (CO-OP) program under Section 1322 of the Patient Protection and Affordable Care Act.  The proposed rule would provide loans to foster the creation of consumer-governed, private, nonprofit health insurance issuers to offer qualified health plans in the Affordable Insurance Exchanges.  The purpose of the program is to create a new CO-OP in every State in order to expand the number of health plans available in the Exchanges with focus on integrated care and greater plan accountability.   

CMS will accept comments on the proposed rule until September 16, 2011.

For additional information, please see the following:

CMS Press Release: NEW PRIVATE NONPROFIT HEALTH PLANS WILL INCREASE COMPETITION, GIVE CONSUMERS AND SMALL BUSINESSES MORE HEALTH INSURANCE CHOICES (7/18/2011)

Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan (CO-OP) Program - Proposed Rule (as published in Federal Register on July 20, 2011)

HHS Releases Proposed Health Insurance Exchange Rules

For additional information, see the following:

After Much Scrutiny, HHS Releases Health Insurance Exchange Rules (Kaiser Health News 7/11/2011)

Affordable Insurance Exchange Announcement (HHS Speech 7/11/2011)

Read the Proposed Rules:

Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans (7/11/2011) 

Patient Protection and Affordable Care Act; Standards Related to Reinsurance; Risk Corridors and Risk Adjustment (7/11/2011)

HHS Announces Additional Funding for State Health Insurance Exchanges

HHS Secretary, Kathleen Sebelius, announced a new funding opportunity for grants to help states continue their work to implement a key provision of the Affordable Care Act – Health Insurance Exchanges. HHS recognizes that states are making progress toward establishing Exchanges but doing so at different paces.  According to the HHS Press Release, states that are moving ahead on a faster pace can apply for multi-year funding and states that are making progress in establishing their Exchange through a step-by-step approach can apply for funding for each project year.

For additional information, see the following:

HHS releases more funding for health insurance exchanges (Healthcare Finance News) (1/20/2011)

HHS announces new resources to help states implement the Affordable Care Act (HHS Press Release) (1/20/2011)

Health Insurance Exchange Establishment Grants Fact Sheet (Healthcare.gov)

NAIC Releases American Health Benefit Exchange Model Act

For additional information, see the following links:

PPACA: NAIC Panel Endorses Exchange Model Act (National Underwriter 11/23/2010)

View the American Health Benefit Exchange Model Act (11/15/2010)