The Department of Health and Human Services has released a final rule to implement state-level Affordable Insurance Exchanges to provide consumers and small employers one-stop shopping for coverage.

The rule is available here and will be published March 27 in the Federal Register. The state exchanges are mandated under the Affordable Care Act by 2014. The government will implement an exchange in states that refuse to do so. At least two states--Kansas and Oklahoma--have returned federal funds to build the exchanges, with political leaders saying the states will use other resources to offer an exchange.

The rule includes standards for establishing and operating an exchange, participating insurance plans, determining eligibility of health plan and an individual to enroll in the exchange, and employer eligibility to participate in certain options for small businesses.

Nine parts of the rule are being issued as an interim final rule with public comment. The parts cover helping individuals apply for advance payments of a premium tax credit, certain Medicaid and CHIP regulations, options for conducting eligibility determinations, timeliness standards for eligibility determinations, eligibility for cost-sharing reductions, verification of applicants for special circumstances, timeliness transmission of certain information, and agreements between agencies administering insurance affordability programs.

More information is available here.

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access