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- May 14, 2014
Health Advocate: Special Enrollment Periods
Read moreOver 8 million people are now covered by health insurance thanks to open enrollment in the federal and state healthcare marketplaces. But, what about those who missed out on the open enrollment? In certain circumstances, such as loss of insurance coverage or other life changes, they may be eligible…
- April 29, 2014
Re: California’s Bridge to Reform Demonstration (No. 11-W-00193/9)
Read moreThere are three major components of the CCI. As drafted, the amendment repeatedly fails to effectively delineate what changes are occurring under each of these separate components. The amendment frequently conflates the three components of the CCI, muddling an already complicated set of changes. The amendment should set forth,…
- April 29, 2014
Comments on All Plan Letter: Continuity of Care: Definition and Practice
Read moreWith the transition of seniors and persons with disabilities (SPDs) into managed care in 2011, we learned that COC is arguably the most critical factor in successfully transitioning high need beneficiaries into a new health care setting. The poor performance of COC protections led to significant, and at times…
- April 29, 2014
Lessons from CA: Exchange Eligibility Appeals under the Affordable Care
Read moreSection 1411(f) of the Affordable Care Act requires the HHS Secretary to establish an appeals process related to eligibility determinations made by Exchanges, including among other things, eligibility for enrollment in a QHP and eligibility for premium tax credits and cost-sharing reductions. The federal Department of Health & Human…
