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.
Webinar: Considerations for 2016 Health Insurance Rate Development, Filing and Review
Ken Ehresmann and Julia Lerche, Wakely Consulting Group
For the first time, many issuers will have a full year of claims experience upon which to base their ACA rates for 2016. Though there will continue to be some unknowns, such as the final 2014 risk adjustment transfers and the health status of those who continue to take up insurance, the availability of 2014 claims data will change the way rates are developed and reviewed for 2016. This webinar explored the considerations for 2016 rate development, filing and review based on a compilation of CMS regulations and guidance as well as insights from Wakely Consulting Group Actuaries.
The webinar examined these and other changes that will impact 2016 rate filings and rate review, including changes announced in the 2016 Notice of Benefit and Payment Parameters, the 2016 Issuer Letter, and QHP and Unified Rate Review templates and instructions. It also included a discussion of the new requirements for Effective Rate Review programs related to public disclosure of rate filings.
The webinar slides can be found at the “download” button and a webinar recording can be found here.