Filed Under:Health Insurance, Individual Health

HHS gives exchange partnership guidance

Secretary Sebelius speaks at a health care round table discussion in this 2011 file photo in Seattle. (AP Photo)
Secretary Sebelius speaks at a health care round table discussion in this 2011 file photo in Seattle. (AP Photo)

State-based health insurance exchanges in California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah were conditionally approved to operate by the Department of Health and Human Services (HHS), Secretary Kathleen Sebelius announced today. Arkansas was conditionally approved to operate a hybrid state partnership exchange.

The Utah exchange interests some for its flexibility because it is limited and only applies to small employers, not the individual market.

While the law does not allow HHS to completely delegate QHP certification to states with an FFE, HHS said it will work with states to agree upon processes that maximize the probability that HHS will accept state recommendations without the need for duplicative reviews from HHS. Specifically, HHS will accept or respond to state QHP recommendations within 14 business days of receipt, on the condition that the state has followed processes previously outlined processes and agreements.  

HHS said it does not intend to re-review QHP data or otherwise duplicate work performed by the state. HHS will notify the state in writing of any concerns that preclude HHS approval of its recommendations; the state will have nine business days following this notification to respond to HHS’ concerns and request reconsideration of HHS’ decisions. HHS will notify the state of its final decision and basis for the decisions within five business days of receipt of the state’s response, it said.

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Nichole Morford

Nichole Morford
Managing Editor

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