Agency Finalizes Affordable Care Provisions

     WASHINGTON (CN) – The Department of Health and Human Services has implemented Affordable Care Act provisions that aim to better coordinate coverage for children and Medicaid subscribers.
     As part of President Barack Obama’s health care reform, individuals and small businesses may purchase private insurance through marketplaces called “exchanges,” starting next year.
     The department has issued a regulation meant to give each state “substantial discretion in the design and operation of the exchange established by the state, with greater standardization provided where directed by the statute or where there are compelling practical, efficiency or consumer protection reasons.”
     The rule also “updates and simplifies the complex Medicaid premium and cost sharing requirements” to help states identify flexibility in cost-sharing and to promote efficiency of services, the department wrote.
     The department addressed comments about the rule, including comments on the complexity of the rules and the short time frames given to implement them.
     “We recognize that the timing of this final rule may result in implementation challenges, especially from a systems perspective,” the department wrote.
     “As such, we have evaluated the provisions of the January proposed rule and are finalizing in this rule only those provisions that we believe states are already in the process of implementing or must be finalized to meet statutory deadlines. The remaining provisions of the proposed rule will be addressed at a later date.”
     The department also proposed revisions to regulations involving the Children’s Health Insurance Program (CHIP), including the prohibition on waiting periods of more than 90 days, and exemptions for waiting periods. “While we acknowledge the commenters’ concerns related to the continuation of waiting periods for children in 2014, we also see a need to permit states flexibility to determine an appropriate substitution prevention strategy, with a full range of options from monitoring to imposition of waiting periods up to 90 days,” the department wrote. “Some states have already eliminated their CHIP waiting periods and we encourage other states to consider taking this step.”

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