June 2014 Update

The Healthy Indiana Plan 2.0 (HIP 2.0) waiver proposal ends its public comment period and will soon go to federal government for review. A new final rule includes fines for individuals and organizations providing consumer assistance in the federal marketplace and additional information is released related to special enrollment periods and ACA Implementation. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage.

HIP 2.0 Details

  • The Governor’s HIP 2.0 waiver proposal completes its 30-day public comment period on June 21st and will then go to the Centers for Medicare and Medicaid Services (CMS) for review.
  • What you need to know: The HIP 2.0 waiver aims to dramatically change the way the Medicaid program works in Indiana. The proposal includes three HIP plan types, one that coordinates with employer-sponsored plans and two that operate under the managed care model. The state of Indiana is also submitting a request to extend the current HIP program beyond 2014 in the event that the HIP 2.0 Waiver is not approved. For more details of the HIP 2.0 waiver proposal, please CLICK HERE. If you or your patients / clients have questions about a how this new plan will impact insurance options, you may direct them to a ClaimAid advocate or CONTACT US.

Finalized Federal Rule Includes Fines for Consumer Assistance Entities

  • Effective July 28, 2014, organizations and their employees may be subject to fines from CMS for violating federal consumer assistance regulations.
  • What you need to know: Indiana organizations operating as Certified Application Counselor Designated Organizations (CDOs) are subject to new regulations, including receiving Civil Money Penalties (CMPs) for violating federal requirements. “The final rule provides that HHS may impose CMPs against Navigators, non-Navigator assistance personnel, certified application counselor designated organizations, and certified application counselors in FFEs, if these entities and/or individuals violate Federal requirements applicable to their activities.” To read the complete final rule, please CLICK HERE.

Additional Information Released of Special Enrollment Periods and ACA Implementation

  • The Centers for Medicare & Medicaid Services (CMS) has provided additional guidance on special enrollment periods and hardship exemptions under the Affordable Care Act (ACA)
  • What you need to know: CMS issued new guidelines for hardship exemptions, special enrollment periods for individuals eligible for or enrolled in COBRA and special enrollment periods for individuals whose plans are renewing outside of open enrollment. For the complete Special Enrollment Period FAQ, please CLICK HERE. For the updated Department of Labor (DOL) Model Notices for COBRA, out-of-network and out-of-pocket charges please CLICK HERE. If you or your patients / clients have questions about the new guidelines, you may direct them to a ClaimAid advocate or CONTACT US.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at jhopkins@claimaid.com.