The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Issuer Essential Health Benefits Crosswalk and Certification
Georgetown University Health Policy Institute
The Issuer Essential Health Benefits (EHB) Crosswalk and Certification has been developed by the Georgetown University Health Policy Institute to help insurance regulators ensure that product filings include the required EHBs as set forth in the applicable state benchmark plan. Regulators can use the tool provided here, requiring issuers to complete the Crosswalk and Certification by: (i) describing each benefit as set forth in the state’s benchmark plan (including applicable page numbers); (ii) describing the corresponding benefit in the issuer’s product filing (including applicable page numbers); and (iii) certifying that (a) the information in the Crosswalk and Certification is accurate and complete and (b) the product filing includes all required essential health benefits as set forth in the state’s benchmark plan. The issuer completed Crosswalk and Certification is intended to increase the efficiency of the form review process by allowing form reviewers to quickly find and verify that the product under review meets all applicable EHB requirements. The tool is word document format and is designed to be modified to meet state-specific needs.