Managers of the 17 new state-based public exchanges program will have to send formal annual reports to Washington starting April 1, 2015.
Officials at the Center for Consumer Information & Insurance Oversight — the arm of the U.S. Department of Health and Human Services responsible for overseeing the start of the exchange program — has described the annual reporting system in a fact sheet aimed at exchange managers.
HHS already asks the state-based Patient Protection and Affordable Care Act exchanges to publish enrollment data and other performance data in a standard format every month.
HHS also will require the exchanges to send in quarterly “performance metrics” reports, annual metrics reports and regular reports on use of federal grant money.
When the exchanges submit the formal annual reports, they will have to attest to the accuracy of the data in the performance reports, and also provide independent audits of financial and program integrity activities.
The exchanges will also have to document efforts to protect applicants and consumers from discrimination, fix any eligibility determination errors, and minimize fraud and abuse.
Exchanges will have to submit the annual reports through a CMS system for exchanges — the State Exchange Resource Virtual Information System.