New Process Planned for|’Affordable Care’ Waivers

WASHINGTON (CN) - States looking to improve on the standards in President Barack Obama's Patient Protection and Affordable Care Act will be working with a new review process, according to a proposal from the Department of Health and Human Services.

Under the proposed process, HHS would have to complete an initial compliance review of a proposed waiver to determine if the application is complete, within 45 days.

Once the preliminary review is complete and a state has the opportunity to provide any information found lacking, the application is considered accepted by the department, and a 180 day public notice and decision making period begins.

Approval of waivers will depend on the extent to which a state shows that the state will be providing coverage that is at least as comprehensive as the coverage defined in the act, and that there still will be cost sharing protections against excessive out-of-pocket spending that are at least as affordable as those defined by the act.

To meet these standards, the states will have to submit detailed actuarial and economic analyses proving effectiveness, and budget plans showing that any waiver is budget neutral to the federal government for at least 10 years.

The department is asking for public comment on how far in advance of the proposed effective date a waiver should have to be submitted. Preliminarily, it assumes waivers would be implemented a year after they were granted.

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