The Department of Health and Human Services (HHS) today awarded nearly $220 million in Affordable Insurance Exchange grants to 13 more states to help them create exchanges, bringing the total number of states moving toward creating exchanges to 29. Little Rhode Island is the first state receiving a Level Two grant, which provides multi-year funding to states further along. The other 12 are receiving level one grants.
HHS also announced a six-month extension for level one establishment grant applications, to June 29, 2012, from Dec. 30 of this year, a month away, and outlined in guidance further modifications, future guidance and new tweaks on various other exchange deadlines and parameters.
This extension was made to accommodate the accommodate state legislative sessions and to give states more time to apply.
Level one grants, which provide one year of funding to states that have already made progress using their exchange planning process.
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Under the Affordable Care Act, states must ensure that their Exchanges are self-sustaining by Jan. 1, 2015.
Forty-nine states and the District of Columbia have already received planning grants, and 45 states have consulted with consumer advocates and insurance companies. Only 13 states have passed legislation to create a health care exchange, but 49 states and D.C. have already received planning grants and 45 have consulted with necessary interested parties–industry and consumer advocates–in their state.
The state exchanges–one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs–are a big part of the Patient Protection and Affordable Care Act (PPACA). The health care reform law gives states the freedom to design their affordable insurance exchanges.
To help with policy-making at the state level, HHS’s key agency for implementation of the exchanges released today a set of Frequently Asked Questions (FAQs) in anticipation of state legislative sessions beginning in January.
The guidance provided by the Centers for Medicare & Medicaid (CMS) clarified that exchange grants canindeed be used to build a state Exchange that is operational after 2014; that state-based exchanges will not be charged for accessing Federal data needed to run exchanges in 2014; and that state insurance rules and operations will continue even if the federal government is facilitating a state’s exchange.
CMS also said network adequacy standards must ensure enrollees a sufficient choice of providers, consistent with HHS regulations.
If it has not, then HHS would step in and develop it for the purposes of the federally facilitated exchange, but it would use a standard such as the NAIC’s Network Adequacy Model Act to do so, CMS said.
HHS is also currently working to determine the extent to which activities like the review of rates and benefit packages are already conducted by State insurance departments and how these responsibilities could be recognized as part of the certification of qualified health plans (QHPs) by a federally facilitated exchange. HHS may use states’ rate review program in place to the extent practicable and where legally permissible, CMS suggested.