Health Law Daily Wrap Up, HEALTH CARE REFORM NEWS—CMS announces $54 million in funding to help consumers navigate health insurance exchanges, (Apr 10, 2013)

By Sheila Lynch-Afryl, JD, MA

CMS has announced funding of up to $54 million to help consumers navigate health insurance exchanges. According to CMS, “navigators” will play an important role in exchanges by assisting consumers with enrollment and providing fair and impartial information. Navigators will conduct outreach and education activities to raise awareness about the marketplace. They will also provide accurate, unbiased information to consumers, including information about health insurance, qualified health plans, and public programs, and assist consumers in choosing a qualified health plan.

This funding opportunity is open to self-employed individuals and private and public entities. 45 C.F.R. sec. 155.210 requires that at least two types of entities serve as navigators in each exchange and that at least one navigator be a community- and consumer-focused nonprofit. Applicants, according to CMS, should have expertise in eligibility and enrollment rules and procedures; qualified health plan options and insurance affordability programs; the needs of underserved and vulnerable populations (such as rural populations and individuals with limited English proficiency); and privacy and security standards. Applications are due by June 7, 2013.

The Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) authorized health insurance exchanges, which will be available beginning October 1, 2013, as well as navigators to help guide consumers. On April 3, 2013, CMS released a proposed rule (78 FR 20581) establishing standards for navigators in federally facilitated and state partnership marketplaces.

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