THE NAVIGATORS > Patient Protection and Affordable Care Act; Exchange Functions < MUST READ! #tcot

 

DEPARTMENT OF HEALTH AND HUMAN SERVICES
45 CFR Part 155
[CMS-9955-P]
RIN 0938-AR75
Patient Protection and Affordable Care Act; Exchange Functions: Standards for
Navigators and Non-Navigator Assistance Personnel
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and
Human Services (HHS)
ACTION: Proposed rule.
SUMMARY: The proposed regulations would create conflict-of-interest, training and
certification, and meaningful access standards applicable to Navigators and non-Navigator
assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges,
and to non-Navigator assistance personnel in State-based Exchanges that are funded through
federal Exchange Establishment grants. These proposed standards would help ensure that
Navigators and non-Navigator assistance personnel will be fair and impartial and will be
appropriately trained, and that they will provide services and information in a manner that is
accessible.
The proposed regulations would also make two amendments to the existing regulation for
Navigators that would apply to all Navigators in all Affordable Insurance Exchanges
(Exchanges), including State-based Exchanges, clarifying that any Navigator licensing,
certification, or other standards prescribed by the state or Exchange must not prevent the
application of the provisions of title I of the Affordable Care Act; and adding to the list of
entities ineligible to become Navigators, those entities with relationships to issuers of stop loss
CMS-9955-P 2
insurance, including those who are compensated directly or indirectly by issuers of stop loss
insurance in connection with enrollment in Qualified Health Plans or non-Qualified Health
Plans. The proposed regulations would also clarify that the same ineligibility criteria that apply
to Navigators would also apply to non-Navigator assistance personnel providing services in any
Federally-facilitated Exchanges, including in State Consumer Partnership Exchanges, and to
federally funded non-Navigator assistance personnel in State-based Exchanges.
DATES: To be assured consideration, comments must be received at one of the addresses
provided below, no later than 5 p.m. on [OFR–insert date 30 days after date of publication in
the Federal Register].
ADDRESSES: In commenting, please refer to file code CMS-9955-P. Because of staff and
resource limitations, we cannot accept comments by facsimile (FAX) transmission.
You may submit comments in one of four ways (please choose only one of the ways
listed):
1. Electronically. You may submit electronic comments on this regulation to
http://www.regulations.gov. Follow the “Submit a comment” instructions.
2. By regular mail. You may mail written comments to the following address ONLY:
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Attention: CMS-9955-P,
P.O. Box 8010,
Baltimore, MD 21244-1850.
Please allow sufficient time for mailed comments to be received before the close of the
comment period.
CMS-9955-P 3
3. By express or overnight mail. You may send written comments to the following
address ONLY:
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Attention: CMS-9955-P,
Mail Stop C4-26-05,
7500 Security Boulevard,
Baltimore, MD 21244-1850.
4. By hand or courier. Alternatively, you may deliver (by hand or courier) your written
comments ONLY to the following addresses prior to the close of the comment period:
a. For delivery in Washington, DC–
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Room 445-G, Hubert H. Humphrey Building,
200 Independence Avenue, S.W.,
Washington, DC 20201.
(Because access to the interior of the Hubert H. Humphrey Building is not readily
available to persons without federal government identification, commenters are encouraged to
leave their comments in the CMS drop slots located in the main lobby of the building. A stampin
clock is available for persons wishing to retain a proof of filing by stamping in and retaining
an extra copy of the comments being filed.)
b. For delivery in Baltimore, MD–
Centers for Medicare & Medicaid Services,
CMS-9955-P 4
Department of Health and Human Services,
7500 Security Boulevard,
Baltimore, MD 21244-1850.
If you intend to deliver your comments to the Baltimore address, call telephone number
(410) 786-9994 in advance to schedule your arrival with one of our staff members.
Comments erroneously mailed to the addresses indicated as appropriate for hand or
courier delivery may be delayed and received after the comment period.
For information on viewing public comments, see the beginning of the
“SUPPLEMENTARY INFORMATION” section.
FOR FURTHER INFORMATION CONTACT:
Joan Matlack, (888) 393-2789.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All comments received before the close of the comment
period are available for viewing by the public, including any personally identifiable or
confidential business information that is included in a comment. We post all comments received
before the close of the comment period on the following Web site as soon as possible after they
have been received: http://www.regulations.gov. Follow the search instructions on that Web site
to view public comments.

MORE the PDF > http://www.ofr.gov/OFRUpload/OFRData/2013-07951_PI.pdf

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