CMS Issues Final Rule on Navigators, Risk Corridors for 2015

The CMS on Friday issued its final rule for exchange and insurance market standards for 2015 and beyond, a potpourri of policies that address consumer notices, quality reporting and enrollee satisfaction surveys, the Small Business Health Options Program (SHOP), standards for navigators and other consumer assisters, and policies regarding the premium stabilization programs, among others.

Its navigator standards are likely to anger state officials who have tried to regulate navigators in their jurisdictions but it may bring smiles to insurers who will receive subsidies for high-cost enrollees at lower cost levels.

The agency is sticking by its plans to lessen state control over navigators by preempting state laws, or portions of them, if they “prevent the application of the provisions of Title I of the Affordable Care Act,” the CMS said.

Throughout 2013, numerous, mostly GOP-led states passed laws limiting navigator activities. Such measures included stringent restrictions on the advice navigators can offer consumers.

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Source: Modern Healthcare