Managing State-Level ACA Implementation Through Interagency Collaboration
Shelly Ten Napel, MSW, MPP, Kyla Hoskins, MPH, Enrique MartinezVidal, MPP and Heather Howard, J.D
“Managing State-Level ACA Implementation Through Interagency Collaboration” was developed by Shelly Ten Napel and the State Network team to describe the early lessons learned from state officials and technical experts related to the leadership and coordination strategies needed to successfully implement the Affordable Care Act (ACA) at the state level. The brief:
– Discusses the value of leadership and a clear vision;
– Outlines specific interagency collaboration strategies being used by states, from low-tech solutions, such as regular meetings and clear delineation of roles and responsibilities, to higher-tech tools including document-sharing and project management software;
– Provides concrete examples of work plans and formal memorandums of understanding (MOUs); and
– Explores issues raised by:
– the need to procure and develop new information technology (IT) systems;
– the imperative to consult with various stakeholders; and,
– the unique challenges related to Health Benefit Exchanges (Exchanges), which may or may not be a formal part of state government.
The brief is designed to provide practical insights and tools for states. For states in which planning is already well underway, it provides suggestions on ways to get beyond existing challenges and barriers. It can be used to check current task lists to ensure that all important topics are being contemplated. For states in which planning is just getting started, it can serve as a comprehensive primer. You will find the following tools:
– Model high-level Exchange timeline
– Milestones for ACA implementation
– Exchange work plan template
– Division of Insurance work plan template
– Division of Insurance self-audit timeline
– Medicaid work plan template
– Checklist of areas where Exchanges will need MOUs with Medicaid programs and Divisions of Insurance
At the end of the public health emergency (PHE), people currently enrolled in Medicaid and the Children’s Health Insurance Program are at risk of losing their coverage unless state Medicaid/CHIP agencies take steps to update enrollee mailing addresses and other contact information. This expert perspective examines the information technology system, policy, and operational strategies states can consider to update key enrollee contact information to ensure eligible enrollees are able to keep or transition to new affordable health coverage at the end of the PHE.
On October 7, the U.S. Departments of Health and Human Services (HHS), Treasury, and Labor (DOL) and the Office of Personnel Management (OPM) published a third rule implementing the No Surprises Act (NSA), the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. This third rule, an interim final rule, provides details on the independent dispute resolution process (IDR), good faith estimates for enrollees on the cost of services, the dispute resolution process for uninsured patients, and external review. This expert perspective summarizes the provisions of the IFR and notes particular implications for state regulators.