"[More than 1,000 consumers nationally

... were asked about attitudes or their experience when they received medical bills for their out-of-pocket costs. And half of U.S. consumers said their out-of-pocket medical costs were more than they expected. And of the 50%, 33% said much more than expected and 17% slightly more than expected. This raises policy questions and issues with respect to how [health plans] present information at open enrollment and throughout the experience."

—Robin Gelburd, president of New York-based FAIR Health, told AIS's Health Plan Week.

$67 million

... in grant funding will be awarded by CMS to support outreach efforts to connect people with navigators who can help them understand the coverage options and financial assistance programs on insurance exchanges, the agency announced on Sept. 4.

"Oftentimes [cybersecurity strategies in health care]

...are just missing the basic, motherhood and apple pie, what we call the blocking and tackling of security — just doing the basics well. Sometimes that's hard, but a lot of times organizations feel like they have to do something super sophisticated, like threat intel sharing, when just keeping your systems updated with the latest software and patches is what you need to do to protect from most of the attacks."
— Stephen Boyer, cofounder and chief technology officer at BitSight Technologies, told AIS's Report on Patient Privacy.

HHS takes next step in advancing health equity through the Affordable Care Act

HHS NEWS

FOR IMMEDIATE RELEASE

September 3, 2015

Contact: HHS Press Office 202-690-6343

HHS takes next step in advancing health equity through the Affordable Care Act

Proposed rule implements new protections against sex discrimination; enhances language assistance; protects individuals with disabilities; and extends to insurers participating in Health Insurance Marketplaces

Washington, DC-- Today, the Department of Health and Human Services (HHS) issued a proposed rule to advance health equity and reduce disparities in health care.  The proposed rule, Nondiscrimination in Health Programs and Activities, will assist some of the populations that have been most vulnerable to discrimination and will help provide those populations equal access to health care and health coverage.

Section 1557 of the Affordable Care Act (ACA) extended civil rights protections banning sex discrimination to health programs and activities.  Previously, civil rights laws enforced by HHS’s Office for Civil Rights (OCR) barred discrimination based only on race, color, national origin, disability, or age. The proposed rule also extends al l civil rights obligations to the Health Insurance Marketplaces and HHS health programs and activities, and clarifies the standards HHS applies in implementing Section 1557 across all bases of discrimination.

The proposed rule establishes that the prohibition on sex discrimination includes discrimination based on gender identity.  It also includes requirements for effective communication for individuals with disabilities and enhanced language assistance for people with limited English proficiency.

“This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our health care system,” Health and Human Services Secretary Sylvia M. Burwell said. “This is another example of this Administration’s commitment to giving every American access to the health care they deserve.”

While OCR has already been accepting complaints under the ACA, the proposed rule makes clear that individuals can seek legal remedies for discrimination under Section 1557.

Today’s proposed rule applies to Health Insurance Marketplaces, any health program that HHS itself administers, and any health program or activity, any part of which receives funding from HHS, such as hospitals that accept Medicare patients or doctors who treat Medicaid patients.  Finally, the proposed rule extends these nondiscrimination protections to individuals enrolled in plans offered by issuers participating in the Health Insurance Marketplaces and explicitly bars any marketing practices or benefit designs that discriminate on the basis of race, color, national origin, sex, age, or disability.  All the plans of insurers participating in the Marketplace are covered by the proposed rule.

The proposed rule makes clear HHS’s commitment, as a matter of policy, to preventing discrimination based on sexual orientation, and requests comment on how a final rule can incorporate the most robust set of protections  against discrimination that are supported by the courts on an ongoing basis. 

The proposed rule requests comment on whether Section 1557 should include an exemption for religious organizations and what the scope of any such exemption should be.  Nothing in the proposed rule would affect the application of existing protections for religious beliefs and practices, such as provider conscience laws and the regulations issued under the ACA related to preventive health services.

The proposed rule includes a number of new protections. Among them:

• Women must be treated equally with men in the health care they receive.  Other provisions of the ACA bar certain types of sex discrimination in insurance, for example by prohibiting women from being charged more than men for coverage.  Under Section 1557, women are protected from discrimination not only in the health coverage they obtain but in the health services they seek from providers. 
• Individuals may not be subject to discrimination based on gender identity. For example, some insurance policies have historically contained categorical exclusions on coverage of all care related to gender transition.  Those categorical exclusions are prohibited under the proposed rule.  Individuals must also be treated consistent with their gender identity, including in access to facilities.
• The rule bolsters language assistance for people with limited English proficiency, so that individuals are able to communicate more effectively with their health care providers to, for example, describe their symptoms and understand the treatment they have been prescribed.  The proposed rule provides clear guidance on the requirements of the law with regard to provision of language services, such as oral interpreters and written translations. 
• For individuals with disabilities, the rule contains requirements for the provision of auxiliary aids and services, including alternative formats and sign language interpreters, and the accessibility of programs offered through electronic and information technology. 

The proposed rule is open for public comment through November 6, 2015 and is available at: https://www.federalregister.gov/public-inspection.

For more information, including a fact sheet and Frequently Asked Questions, visit:  ttp://www.hhs.gov/ocr/civilrights/understanding/section1557/index.html.

June 30, 2015 Effectuated Enrollment Snapshot

FACT SHEET FOR IMMEDIATE RELEASE September 8, 2015 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries   June 30, 2015 Effectuated Enrollment Snapshot On June 30, 2015, about 9.9 million consumers had effectuated Health Insurance Marketplace coverage – which means those individuals paid their premiums and had an active policy at the end of June.1 These numbers are consistent with HHS’s effectuated enrollment target of 9.1 million for the end of 2015. Of the approximately 9.9 million consumers nationwide with effectuated Marketplace enrollments at the end of June 2015, about 84 percent, or more than 8.3 million consumers, were receiving an advanced premium tax credit (APTC) to make their premiums more affordable throughout the year. The average APTC for those enrollees who qualified for the financial assistance was $270 per month.2   There were 7.2 million consumers with effectuated enrollments at the end of June 2015 through the 37 Federally-Facilitated Marketplaces (including State Partnership Marketplaces) and supported State-based Marketplaces (collectively known as HealthCare.gov states) and 2.7 million through the remaining State-based Marketplaces.3 “Consumers from coast-to-coast are continuing to show how important health coverage is to their families,” said HHS Secretary Sylvia Burwell. “Millions of Americans are benefiting from the peace of mind that comes with having quality coverage at a price they can afford as they access coverage through the Affordable Care Act’s Marketplace.” CMS releases Marketplace state-by-state effectuated enrollment snapshots on a quarterly basis, detailing how many consumers have an effectuated enrollment, how many are benefiting from APTC and/or cost-sharing reductions (CSR), and the distribution of effectuated enrollment by qualified health plan metal level. The first Marketplace enrollment snapshot for 2015 was released on June 2 and covered effectuated enrollment through March 31, showing that 10.2 million consumers had effectuated coverage. Today’s snapshot also provides an update through June 30 on the number of individuals with citizenship, immigration status, or household income data matching issues. The Marketplace effectuated enrollment snapshot provides point-in-time estimates. CMS expects enrollment numbers will change over time as consumers find other coverage or experience changes in life circumstances such as employment status or marriage, which may cause consumers to change, newly enroll in, or terminate their plans.4 For more in-depth information, the full fact sheet can be viewed at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-09-08.html.   ###   Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

CMS National Training Program

Medicare Open Enrollment Bootcamp Webinar The CMS National Training Program will host a Medicare Open Enrollment Bootcamp for Partners on Thursday, September 22 from 1:30 – 3:30 pm ET. This webinar will feature topics including Understanding Medicare Open Enrollment, 1-800-MEDICARE Open Enrollment Best Practices and User Hints, Guide to Consumer Mailings, a demonstration of the Plan Finder tool, and Hosting a Successful Enrollment Event. To join the webinar visit https://webinar.cms.hhs.gov/openenrollmentbootcamp092215/. Training Webinars Medicare Learning Series – Overview of Medicare's Hospice Benefits September 10, 2015                       1:00 – 2:30 pm ET Join the CMS National Training Team as we provide an overview of Medicare's Hospice benefits. Join the audio portion of the webinar on 1-877-267-1577, conference ID: 998 275 879 and join the webinar at https://webinar.cms.hhs.gov/ntplearnseriessep2015/ .   Monthly Update Webinar October 6, 2015                               2:30 – 3:30 pm ET Each month we offer an update webinar featuring subject matter experts who share information on current topics. Join the audio portion of the webinar on 1-800-603-1774, conference ID: 66877216 and join the webinar at https://webinar.cms.hhs.gov/ntpupdatewebinar100615/   New Training Materials Spanish version of 2015 Medicare Advantage Plans and Other Medicare Plans Training Presentation & Workbook–These materials explain the rights and protections afforded to you whether you enrolled in Original Medicare, a Medicare Advantage Plan (like a Health Maintenance Organization or Preferred Provider Organization), other Medicare health plan (like a Medicare Cost Plan or Program of All-Inclusive Care for the Elderly), or a Medicare Prescription Drug Plan. Spanish 2015 Coordination of Benefits Training Presentation & Workbook – These materials explain the Coordination of Benefits when people have Medicare and certain other types of health coverage. Spanish 2015 Medicare Part D Prescription Drug Coverage Training Presentation & Workbook – These materials explain Medicare Prescription Drug Coverage under all parts of Medicare. You’ll learn to differentiate Medicare Part A, Part B, and Part D drug coverage, summarize Part D eligibility and enrollment requirements, and compare and choose drug plans. New/Updated CMS Publications Medicare Coverage of Kidney Dialysis and Kidney Transplant Services Your Guide to Choosing a Nursing Home or Other Long-Term Care A Quick Look at Medicare

 

Agent/Broker Reminder: Guidance on Plan Year 2016 FFM Registration and Training for Agents and Brokers Webinar Sessions This Month

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that plan year 2016 Federally-facilitated Marketplace (FFM) agent and broker registration and training is now available. CMS is hosting three remaining webinar sessions in September for agents and brokers on the plan year 2016 FFM registration and training process. The sessions will walk agents and brokers through the new registration process, give a brief overview of the SHOP Marketplace, and describe the new option to complete training through one of the CMS-approved vendors. Each webinar will include a web-chat question and answer session immediately following the presentation. CMS will hold webinars on the following dates:

•  Thursday, September 17, 2015 from 11:00 AM – 12:30 PM ET
•  Friday, September 18, 2015 from 1:00 PM – 2:30 PM ET
•  Friday, September 25, 2015 from 1:00 PM – 2:30 PM ET

Please register for only one webinar session, as space is limited and each session will provide identical content. To register, please log in to www.REGTAP.info and complete the following steps:

1. Select "Training Events" from "My Dashboard."
2. Select the "View" icon next to event Title " Guidance on Plan Year 2016 FFM Registration and Training for Agents and Brokers "
3. Select "Register Me."

If you require further assistance, you may contact the Registrar at 800-257-9520.