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  • HHS Releases Final Guidance for Exchanges

    Yesterday, the Department of Health and Human Services' (HHS) Center for Consumer Information and Insurance Oversight released the final Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges. Most qualified health plans offered in these exchanges must offer plans that included the 10 mandatory categories of essential health benefits as mandated by the Affordable Care Act, which include rehabilitative and habilitative services.

    The guidance sets out timelines and requirements for state exchange documents (ie, "blueprints") each state must file with HHS. The document explains what type of exchange the state will run and how it will comply with the requirements.

    A complete blueprint and declaration letter (specifying the chosen exchange model) must be submitted no later than November 16 for states seeking to operate a state-based or state partnership exchange for plan year 2016. Those states that submit letters more than 20 business days before the submission of their blueprints may request additional consultation and support from the Centers for Medicare and Medicaid Services to assist in blueprint preparation.

    States that intend to operate in a federally-facilitated exchange but retain control of their own reinsurance programs also must submit a declaration letter by November 16.

    HHS will begin plans to implement a fully federally-facilitated exchange in states that do not submit a blueprint and declaration letter before or by November 16.

    The final guidance was released in conjunction with the first of 4 regional implementation forums that HHS is holding this month in the District of Columbia, Atlanta, Chicago, and Denver.

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