Monthly Archives: September 2016

Reminder: Federally-facilitated Marketplace Assister Conflict of Interest Requirements

Click here to access a tip sheet that addresses specific conflict of interest requirements for Navigators, in-person assisters, and certified application counselors (CACs) in Federally-facilitated Marketplaces (FFMs). These conflict of interest requirements are designed to ensure that assisters and assister organizations do not have relationships that could interfere with their ability to provide unbiased outreach and enrollment assistance to consumers.

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Marketplace Appeals vs. Coverage Appeals Resource

Consumers who don’t agree with a decision by the Marketplace may be able to appeal that decision, and they may also be able to appeal a decision made by their health insurance plan; however, each of those appeals goes through a different process. CMS has released a new resource for assisters to advise consumers on which decisions they can appeal and how to appeal certain decisions depending on who made the decision: the Marketplace or their health

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HRSA Issues Message about 340B Extended Registration Period

The next 340B program registration window will be October 1-17, 2016.  The upcoming registration window is unique in that both the start date and the end date fall on Saturdays, giving the entities one less working day to register.  Therefore, the Office of Pharmacy Affairs (OPA) will extend the upcoming registration period to include October 17, 2016.

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Partner Resource: New Guide to School Based Outreach

The Center for Budget and Policy Priorities (CBPP) posted a new Guide to School-Based Outreach for Health Coverage Enrollment on August 3rd.  This resource builds on CBPP’s decades of health coverage outreach experience and shares successful strategies for school-based outreach, as well as lessons learned, to help groups avoid methods that produce disappointing results. The four section guide is a useful tool for both new and seasoned practitioners

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CMS Releases Data on Projected Trends in National Health Expenditures for 2015 – 2025

On July 13, 2016, the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary (OAct) released data on the most recent projected trends in national health expenditures for 2015-2025. Projected national health spending growth remains lower than in the previous two decades before 2008. Health spending is projected to grow 1.3 percentage points faster the Gross Domestic Product per year over 2015-2025. The publication Health Affairs

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CMS Publishes Health Coverage Tax Credit Hardship Exemption Guidance

On August 12, 2016, CMS announced a hardship exemption that may be claimed through the tax filling process for eligible people who qualify for a Health Coverage Tax Credit (HCTC), but who are not enrolled in HCTC-qualifying health insurance coverage.

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Update on How to Claim Exemptions Based On Tribal or Incarceration Status or Participation in a Health Care Sharing Ministry

Assisters should inform consumers that starting September 1,, 2016 the Marketplace will no longer be processing applications for consumers who apply for exemptions based on tribal or incarceration status or participation in a health care sharing ministry. Instead, consumers can claim these exemptions through the IRS when they file their federal income taxes for the year. More information that can help consumers determine whether they qualify for

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CMS Awards Consumer Assistance Funding to Support 2017 Health Insurance Marketplace Enrollment

With open enrollment for 2017 only a few weeks away, the Centers for Medicare & Medicaid Services (CMS), announced $63 million in Navigator grant awards to returning and new organizations.  These awards will support local in-person assistance to help consumers navigate, shop, and enroll in the wide variety of Marketplace coverage options. This year, 96 returning organizations and 2 new organizations in the state of Hawaii received a grant award. 

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Register for CCIIO’s Assister Forum: Preparing for 2017 Open Enrollment and Beyond on Monday, Sept. 26 via live remote streaming, register by Sept. 22

Please join the Center for Information and Insurance Oversight (CCIIO) Marketplace CEO Kevin Counihan along with CCIIO Consumer Support Group Director Jennifer Beeson and other CMS/CCIIO leadership for a forum on Monday, September 26, 2016 via remote live streaming. This forum will promote best practices and share strategies for enhancing assister capacity to perform outreach, education, and enrollment activities for the 2017 Open Enrollment period

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