CMS proposed rule outlines standards for navigators of health coverage
AHA News Now
Apr 3, 2013
The Centers for Medicare & Medicaid Services today issued a proposed rule adding to previously adopted standards for navigators, which are organizations authorized by the Patient Protection and Affordable Care Act to provide unbiased information to consumers about coverage options in the health insurance exchanges, also known as Health Insurance Marketplaces. The proposed rule also would apply to non-navigator assistance programs and personnel and contains standards for training, conflict of interests, and culturally and linguistically appropriate services. It also adds to the list of entities prohibited from becoming navigators. Finally, it clarifies that grant funding for navigators that operate in states with federally facilitated exchanges and state partnership exchanges will be handled by the federal government. The ACA requires states to establish exchanges to facilitate the purchase of qualified health plans in the individual and small group markets beginning in 2014. For states that do not create an exchange, the Department of Health and Human Services will create and operate a federally facilitated exchange. The proposed rule will be published in the April 5 Federal Register and comments will be accepted for 30 days.