On Friday, HHS and the Department of the Treasury released three proposed rules governing eligibility procedures and tax credits for obtaining health care coverage through the state-based health insurance exchanges, Modern Healthcare reports.
Eligibility Rule
One of the rules calls for coordinating the exchanges with eligibility systems for Medicaid and the Children's Health Insurance Program to streamline the enrollment processes (Zigmond, Modern Healthcare, 8/12). Under the rule, health insurance exchanges would need use a secure interface to share data with government-run health insurance programs.
The rule states, "The proposed eligibility process is designed to minimize opportunities for fraud and abuse, including the use of clear eligibility standards and processes that rely on data sources in an electronic environment."
The verification process would tap into electronic data sources, such as records from the Department of Homeland Security, the Internal Revenue Service or the Social Security Administration (Goedert, Health Data Management, 8/12).
Other Proposed Rules, New Exchange Funding
The other two proposed rules focus on:
In related news, HHS has awarded $185 million in grants to 13 states and Washington, D.C., to help them establish health insurance exchanges (Modern Healthcare, 8/12).