The National Health Law Program (NHeLP) and Community Catalyst, as part of their joint In the Loop project, recently released a very helpful flowchart to assist with the process of re-determinations. The flowchart is below, but if you want to download the PDF, click here. The flowchart can also be found on our Resources & Links page under “Enrollment Resources […] Read More »
CMS Releases Training for Navigators
Earlier this week, the Centers for Medicare and Medicaid Services (CMS) released the training for navigators and other in-person assisters in the federally facilitated and federal-state partnership marketplaces. To access the training through the Medicare Learning Network, click here. For an explanation and instructions on the training, click here. Read More »
CMS Approves Medicaid Expansion in Pennsylvania
Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced that it had approved Pennsylvania’s proposed approach to Medicaid expansion under the Affordable Care Act. To read the press release which includes the statement of CMS Administrator Marilyn Tavenner, click here. Here is some additional information, courtesy of CMS, which details the Medicaid expansion in […] Read More »
Urban Institute Releases Report on Physician Network Transparency
One of the biggest considerations by consumers when choosing a health plan is which providers are part of the network. Navigators and enrollment specialists may be asked by those they are assisting whether or not a qualified health plan will cover physicians with whom they are already treating. Finding the answers to which providers are […] Read More »
CAC Recertification Request Form is Now Available
On Monday, we reported that the CMS that issued guidance on retraining and re-certification for navigators and certified application counselors (CACs). CMS also recently released the recertification request form which CACs will need to complete. To download this form, click here. Read More »
New Report Addresses the Issues in Pharmacy Benefit Designs
The Georgetown University’s Center on Health Insurance Reforms recently released an issue brief entitled “Specialty Tier Pharmacy Benefit Designs in Commercial Insurance Policies: Issues and Considerations.” A prescription drug benefit can be especially important for people with disabilities as they are considering their options in qualified health plans. This issue brief draws attention to how insurance companies have started treating prescription […] Read More »
CMS Issues Guidance on Navigator and CAC Training & Certification
On Friday, the Centers for Medicare & Medicaid Services (CMS) issued a bulletin providing guidance for training, certification and re-certification for navigators, certified application counselors (CACs) and other enrollment specialists in the federally facilitated marketplaces as well as the state partnership marketplaces. The bulletin addresses the requirements for the training for these programs and answers many […] Read More »
CMS to Send Notices on Data Inconsistencies
Yesterday, CMS issued a press release indicating that it was sending out notices to consumers in federally facilitated marketplace states with data inconsistencies related to citizenship and/or immigration status. The consumer will then have until September 5 to resolve the issue. To read the CMS press release, click here. Read More »
CMS Releases Guidance on Limited Circumstance SEPs
Last week, the Centers for Medicare & Medicaid Services (CMS) issued guidance on assisting consumers who are entitled to special enrollment periods due to the limited circumstances of a “life event.” To read the guidance, click here. The guidance can also be found on our Resources & Links page under “Enrollment Resources – Overview.” Read More »
Understanding the Implications of Re-enrollment
Are you trying to understand the implications for how the federal government proposes to handle re-enrollment in the federally facilitated exchanges? Automatic re-enrollment at the previously determined Advanced Premium Tax Credit (APTC) will occur for the large majority of consumers in the federal marketplace, but this proposal could have significant impact on those consumers who […] Read More »
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