Healthcare Exchange

Funding for Navigator Program Hits Roadblock: Opens Door for Reliance on Existing Broker System

Bernard DiFiore — Wed, 23 May 2012 17:06:00 +0000

A senior health care official with the Obama Administration recently said the funding for navigator programs may not be forthcoming based on legal requirements embedded in the Patient Protection and Affordable Care Act (PPACA), according to InsideHealthPolicy.com.

PCORI Update: Brokers Take Note as Patient-Centered Research Ramps Up

Michael Gomes — Mon, 21 May 2012 22:29:53 +0000

As Brokers prepare for their upcoming role as more active participants in state health insurance exchanges, they may also want to keep an eye on the Patient Centered Outcomes Research Institute (PCORI), now looking to fund patient-centered research. BenefitMall previously discussed in a blog how the Patient Protection and Affordable Care Act (read more

HHS Issues Interim Final Exchange Rules Con’t. – States to Retain Primary Regulatory Authority to Oversee Brokers and Navigators

Michael Gomes — Mon, 14 May 2012 18:08:17 +0000

To conclude our examination of the new exchange rule recently issued by the Department of Health and Human Services (HHS), this blog summarizes the rule’s treatment of states as the primary regulatory authority for both Brokers and navigators. In two previous blogs analyzing the rule’s requirements, we wrote about the new opportunities available to Brokers under the rule, and the rule’s acknowledgment of the important role Brokers can assume in the establishment of new Exchanges.

States Continue to Oversee Brokers

HHS Issues Interim Final Exchange Rules Con’t. New Regulations Anticipate Working with Broker Websites

Michael Gomes — Thu, 10 May 2012 14:17:30 +0000

This posting is the second in a series that more fully explores the new rule issued by the U.S. Department of Health and Human Services (HHS) concerning organization and operation of state health benefit Exchanges. The rule expands on the provisions of Section 1312(e) of the Patient Protection and Affordable Care Act (PPACA), which addresses consumer choice in selecting a qualified health plan, and provides for the enrollment of qualified individuals through agents or brokers.

HHS Issues Interim Final Exchange Rules Acknowledges Important Role of Brokers

Michael Gomes — Mon, 07 May 2012 19:24:34 +0000

The Department of Health and Human Services (HHS ) recently issued a final rule providing states with considerable flexibility in the organization and operation of state-based health exchanges pursuant to the Patient Protection and Affordable Care Act (PPACA).

Webinar Addresses Role of Brokers in State Health Benefit Exchanges

Michael Gomes — Fri, 04 May 2012 22:01:36 +0000

What role should brokers play in state health benefit Exchanges? This was one of several intriguing questions raised by the executive directors of state health benefit Exchanges for California, Colorado and Alabama during a recent webinar. Under the Patient Protection and Affordable Care Act (PPACA), states are required to establish their own public health Exchanges to offer consumers cost-effective insurance options.

Waiting for the U.S. Supreme Court Decision: An Overview of Potential PPACA Outcomes

Michael Gomes — Tue, 10 Apr 2012 22:06:53 +0000

Last month, the United States’ highest court heard oral arguments on what has become the most controversial piece of legislation in recent history, the Patient Protection and Affordable Care Act (PPACA). Many of us wait eagerly for a final decision, which is expected to be published in June. Some key background information is listed below to help put things in perspective.

U.S. Supreme Court Wraps-Up Oral Arguments on PPACA’s Constitutionality by Questioning the Act’s Medicaid Expansion Provision: Justices Now Must Meet in Chambers to Resolve Legal Issues

Michael Gomes — Fri, 30 Mar 2012 12:39:46 +0000

On Wednesday afternoon, the U.S. Supreme Court concluded the final session of oral arguments concerning the Patient Protection and Affordable Care Act (PPACA)’s legality by focusing on the Act’s Medicaid expansion provision and whether it unduly coerces state governments.

Day Three – U.S. Supreme Court Hears Oral Arguments on PPACA’s Missing Severability Clause

Michael Gomes — Thu, 29 Mar 2012 12:37:18 +0000

Yesterday morning the U.S. Supreme Court addressed the complex legal question of whether or not to strike down the entire Patient Protection and Affordable Care Act (PPACA) if the Court finds part of the Act unconstitutional or otherwise illegal.

Day Two – U.S. Supreme Court Hears Oral Arguments on PPACA’s Individual Mandate

Michael Gomes — Wed, 28 Mar 2012 14:21:59 +0000

The U.S. Supreme Court heated up on Tuesday as the Justices heard oral arguments on the Patient Protection and Affordable Care Act (PPACA). The focus of the Court yesterday was on the legality of Act’s individual mandate. The Court is grappling ultimately with the constitutional powers of the federal government to require individuals to purchase health insurance or pay a fine to the IRS. The decision will have historic ramifications.