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Health exchange advisory panel shuts out commercial insurers

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Baton Rouge, La.-based Health Agents for America Inc. has often complained about how clueless managers of the Patient Protection and Affordable Care Act’s public exchange system can be, and how resistant they are even to responding to minor questions and suggestions from producers.

The Centers for Medicare & Medicaid Services (CMS) may have provided a clue about the problem in a recent meeting notice: The body that advises CMS on PPACA exchange issues appears to include no members from traditional commercial health insurers, and no members who operate as traditional commercial health insurance products.

Related: 4 tales from the PPACA agent misery files

CMS, an arm of the U.S. Department of Health and Human Services, published the notice in the Federal Register earlier this month to announce a meeting of the Advisory Panel on Outreach and Education.

The panel is supposed to advise CMS on ideas for helping the PPACA exchange system, Medicaid, Medicaid and the Children’s Health Insurance Program do a better job of reaching out to consumers. It gives its recommendations to Andrew Slavitt, the acting CMS administrator, and other HHS officials.

The panel will hold a full-day public meeting June 22 at the HHS offices in Washington, D.C.

CMS said in a 2011 notice seeking APOE member nominations that panel members can be people who are knowledgeable about health insurers, health plans and health communications.

The new panel meeting notice lists the names and affiliations of the 18 current panel members.

Ten are affiliated with hospitals, health care clinic groups or health care professional groups.

Several are affiliated with specific groups of people, such as young adults. One represents the Chicago-based Healthcare Information and Management Systems Society.

The only member who appears to be associated with an organization involved with providing health insurance is Dr. Roanne Osborne-Gaskin, the senior medical director at MDWise Inc. and MDwiseMarketplace of Indianapolis.

MDWise is a “payvider,” or carrier owned by health care providers, rather than a traditional stand-alone commercial health insurer. The Health and Hospital Corp. of Marion County and Indiana University Health started MDWise to serve vulnerable people in Indiana. The carrier does sell individual commercial coverage in Indiana through the PPACA public exchange program. 

Osborne-Gaskin has been a family physician and a clinical assistant professor of family medicine at Brown University’s medical school. Before she worked for MDWise, she was an associate medical director at Neighborhood Health Plan of Rhode Island, a nonprofit carrier.

Osborne-Gaskin and CMS were not immediately available for comment.

Representatives from a large insurer group and a large producer group were not available to talk about whether they knew of any efforts by producers or representatives from traditional commercial health coverage issuers to apply to serve on the advisory panel.

See also:

What agent groups hate about proposed 2017 PPACA World rules

How the PPACA exchange program still infuriates agents

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