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.
Qualified Health Plan (QHP) Issuer Certification Checklist
Georgetown University Health Policy Institute – Mila Kofman, Katie Dunton and Sally McCarty
The Qualified Health Plan (QHP) Issuer Certification Checklist is a document developed by Georgetown University’s Health Policy Institute that insurance regulators (and/or Exchanges) can use or modify for use in reviewing applications filed by issuers for approval as QHP issuers. In addition to this PDF, the QHP Issuer Certification Checklist is also available in a fill-able Microsoft Word version for easy use and amendment by state regulators. Some QHP issuer certification elements in the checklist require a decision by the state to accept attestation by a carrier or to verify compliance directly through evidence that the requirements have been met. This checklist provides an outline for insurance regulators to ensure that issuers who seek to become QHP issuers are in compliance with Affordable Care Act requirements.