May 24, 2012

HHS Releases Proposed Rule on Health Exchanges

von Briesen & Roper, S.C.
Meghan C. O'Connor
von Briesen & Roper, S.C.
Monday, July 11, 2011
Administrative & Regulatory / Health Law & Managed Care / Insurance Reinsurance & Surety
All Federal / All States
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Today, the U.S. Department of Health and Human Services (HHS) issued a proposed rule that governs how states will build and run Affordable Insurance Exchanges (Exchanges). Established under the Affordable Care Act, Exchanges are state-based marketplaces where individuals and small business can purchase health insurance. If finalized, the rule sets minimum standards for Exchanges, which are set to become operational by January 1, 2014.

In a news release, HHS highlighted two key areas of guidance to states on how to structure their Exchanges:

• Setting standards for establishing Exchanges, setting up a Small Business Health Options Program, performing the basic functions of an Exchange, and certifying health plans for participation.

• Ensuring premium stability for plans and enrollees in the Exchange.

The rule proposes an Exchange approval process, including submission of an Exchange Plan and an operational readiness assessment by HHS. The rule also outlines an Exchange Plan review process similar to Medicaid and CHIP (i.e., a 90-day review period).

More information about Exchanges is available here.

©2012 von Briesen & Roper, s.c

About the Author

Meghan C. O'Connor

Meghan O’Connor is a member of the Health Care Practice Group. Her practice focuses on general health law including managed care and provider contracting, risk management, and regulatory compliance.

Prior to joining von Briesen, Meghan worked for the Centers for Medicare and Medicaid Services where she consulted with states regarding federal health law, regulation and policy, evaluating managed care contracts and conducting compliance reviews.

moconnor@vonbriesen.com
414-287-1586
www.vonbriesen.com

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