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Healthcare Reform

Insights on the ACA: Marketplace Enrollment

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Note: ACA Watch is an ongoing, bi-weekly series with aggregated stories and insights on the latest developments regarding the Affordable Care Act. Look out for it every other Thursday.

Just two weeks remain until the opening of enrollment in the health insurance exchanges (marketplaces), a key component of the Affordable Care Act. Much misinformation and confusion has accompanied the run-up to the Oct. 1 start of open enrollment in the marketplace.

Everyone is likely to hear a lot about the successes and failures of the exchanges in the coming weeks and months. Some of the government contractors responsible for creating key components of the information technology infrastructure that will allow the exchanges to function testified before congress last week that they’ll be ready on time. However, even proponents of the ACA in many states admit that bumps in the road are expected when launching new programs like this. ACA Watch will be monitoring the impact of the exchanges on GHS.

Implementation

State Medicaid Snapshot: ACA Implementation

The National Association of Medicaid Directors (NAMD) released the second edition of an ongoing report, “State Medicaid Snapshot: Affordable Care Act Implementation.” The report is based on the progress and current status of a representative cross-section of states. It describes state successes and challenges to date to implement the Medicaid program changes called for in the ACA. Visit this page for the full report.

State Watch

Pennsylvania to Take Medicaid Funds, with a Catch

Gov. Tom Corbett announced that he would accept federal Medicaid funding to insure hundreds of thousands of Pennsylvanians as part of a broader overhaul of the health-care safety net. Corbett said his proposal would allow new Medicaid recipients to purchase private health insurance, but also would place new requirements on many of the more than one million current adult Medicaid enrollees, including a monthly premium and a job-search mandate. Visit this page for further details.

Industry Watch

CMS Releases FAQs on 90/10 Match for HIE Activities

CMS released a set of FAQs on the 90/10 match available for health information exchange (HIE) activities through the Medicaid Electronic Health Record (EHR) incentive program. States may request the match for two broad categories of their administrative activities related to HIEs:

  1. On-boarding providers onto HIEs.
  2. Design, development and implementation (DDI) of infrastructure that allows providers eligible for the EHR incentive program to meet meaningful use requirements.

The FAQs specify that states can collect a 90/10 match for time – staffing costs in limited circumstances related to on-boarding or to building initial infrastructure. States can also collect enhanced federal funding to update existing HIE infrastructure to align with new Federal HIE guidelines and requirements to exchange data with federal agencies. States cannot use the enhanced match, however, to build or operate a capability that allows beneficiaries to download their information from a state’s MMIS.

The FAQs also lay out the authorities and the administrative processes to request the enhanced match.

Read the guidance here.