Monthly Archives: August 2015

Federal Tort Claims Act (FTCA) Risk Management Virtual Conference – Thursday, September 10, 2015, 10:00am – 3:00pm CT (9:00am – 2:00pm MT)

Join ECRI Institute, on behalf of HRSA, for this free one-day virtual conference featuring expert speakers who will walk through the practical application of risk management principles in response to an adverse clinical event. Learn how to effectively use electronic health records to manage patient care, how listening to patients can help improve patient safety, and how the processes of credentialing, privileging, clinical competence assessment,

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CDC Report Shows 2015 Drop in Rate of Uninsured

KEY TAKEAWAY: Recent results from the National Health Interview Survey indicate a historic drop in the uninsured rate and corresponding gains in private coverage. Assisters can see the information below to learn more, access the full summary of results, and browse reports from previous years. Earlier this month, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) released results from the National

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2016 Assister Training Now Available for Certified Application Counselors (CACs)

KEY TAKEAWAY: As of August 26, 2015, the 2016 Assister Training is available to Certified Application Counselors (CACs) in the Federally-facilitated Marketplace (FFM). The information below includes details on the CAC training process, and notes that the 2016 Assister Training will be available to Navigators and to agents and brokers beginning in September. The Centers for Medicare and Medicaid Services (CMS) is pleased announce that as of August

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Guidance for Issuers on the 2016 Reenrollment Process

KEY TAKEAWAY: CMS has published new guidance for issuers on the 2016 reenrollment process. On August 25, 2015, CMS published a bulletin with operational guidance for issuers on the 2016 reenrollment process in the Federally-facilitated Marketplaces (FFMs), as well as in State-based Marketplaces (SBMs) that use the federal eligibility and enrollment platform. This bulletin replaces last year’s issuer guidance on reenrollment (published December

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NEW CMS Guidance Re-Establishes Same Timing for Renewal and Discontinuation of Coverage Notices

KEY TAKEAWAY: Last year, CMS required health insurance companies planning to discontinue a health coverage product to send notice to consumers who had this coverage at the same time that they sent renewal notices for plans that would continue. This guidance also applies to the 2015-16 Open Enrollment Period.  Assisters can help consumers understand and act on the renewal or discontinuation notices starting on November 1, 2015. On July 7, 2015, CCIIO

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NEW: CMS Reports 950,000 Consumers Used SEPs to Enroll in 2015 Coverage from February 23 – June 30, 2015

KEY TAKEAWAY: CMS has released a report on the number of consumers who signed up for coverage on HealthCare.gov using a special enrollment period (SEP) between February 23 and June 30, 2015. This report shows that individuals and families experience changes throughout the year that make them eligible for Marketplace coverage, and that SEPs are an important tool for helping consumers avoid coverage gaps. Additionally, assisters can use the report’s

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OUTREACH MATERIALS: LIVING WELL TOOLKIT – PROMOTING PREVENTIVE SERVICES

CMS has released a new set of outreach and educational materials in the form of a toolkit titled Living Well, designed to help beneficiaries understand the preventive services available to them under Medicaid and CHIP. Living Well emphasizes the importance of services like regular check-ups, vaccines, and screenings to identify and prevent diseases when they are most treatable. The toolkit features a number of customizable posters, fact sheets, social

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Question on HICS cases: Are you planning to give assisters the ability to view or enter Health Insurance Casework System (HICS) cases?

A1: Yes.  HICS was designed with a user profile for assisters. However, the casework and customer service environment is still evolving and we are not prepared to make it available yet to the assister community. We hope to pilot it with a small group of assisters in 2017 and evaluate its usefulness shortly thereafter to determine if we should do a broader national roll-out in the future.

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New Information on HealthCare.Gov About How Consumers Can Appoint an Authorized Representative for Help Requesting an Appeal

If a consumer wants to designate an Authorized Representative –– like a family member, friend, advocate, or attorney –– to be able to ask for the appeal on behalf of the consumer and/or to speak for them in the appeal, the consumer should complete, sign and send us the Designation of Authorized Representative form you’ll find here. Consumers can submit an authorized representative request at two different times with respect to their eligibility

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Consumers Can Now Mail or Fax the Marketplace Their Completed Appeal Request Forms

CMS has recently added an additional way for consumers to submit a request to appeal Marketplace decisions. Consumers can now fax their appeal requests into the Marketplace, in addition to sending an appeal request by mail. See below for information on how to fax in an appeal request and for how to mail in an appeal request. Here are the ways consumers can request a Marketplace eligibility appeal: Consumers may write an appeal request in the form

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