Regulatory Analysis | Aug 11, 2011

HHS Proposed Rules on Exchange Implementation Requirements

Manatt Health Solutions – Deborah Bachrach, Patricia Boozang, Melinda Dutton and Alice Lam

Health insurance exchanges are the vehicle through which millions of Americans will gain access to coverage beginning in 2014. The U.S. Department of Health and Human Services (HHS) released its initial proposed rules on exchange implementation on July 11, 2011. This issue brief, authored by Manatt Health Solutions, highlights the provisions of the proposed rules that will impact state planning and implementation of exchanges. It summarizes they key provisions across a number of broad categories including exchange establishment, exchange functions, individual enrollment, the Small Business Health Options Program (SHOP), Qualified Health Plan (QHP) accreditation and certification, enrollment periods and effective dates in the individual market, and the exchange establishment process and criteria. The brief also identifies areas in the proposed rules that provide new insight on exchange development, for example the introduction of a new “state partnership model” for exchange development.