CMS releases guidance on state partnership exchanges

The Centers for Medicare & Medicaid Services (CMS) released a 57-page guidance document for qualified health plan issuers participating in federally-facilitated state partnership exchanges, which are set to go live October 2013.

Contents feature guidance on a wide range of areas, including: certification standards for quality health plans; qualified health plan certification process in federally-facilitated exchanges, including state partnership exchange; qualified health plan performance and oversight; stand-alone dental plans; consumer enrollment and premium payment; consumer support; and tribal relations and support.

According to the document, state plan management partnership exchanges will have flexibility when applying certification standards and adjust processes, and the guidance spells out the areas where flexibility is permitted.

CMS clarified that policies in the guidance “apply to the 2014 coverage year and beyond” and said it intends to issue similar letters “to provide operational updates to qualified health plan issuers, but we do not intend to issue these letters more than annually.”

According to the latest information on the CMS website, conditionally approved state marketplaces include: California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont and Washington. Conditionally approved state partnership marketplaces include: Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire and West Virginia.