Exchange Plan Rating Systems
A plan rating system, which allows consumers to see ratings of Exchange plans on the basis of quality, can contribute to strategic goals of improving transparency and informed decision making.
*Milestone details:
*Full name: Adopt a plan rating system that meets or exceeds standards developed by the federal government.
*Relevance to the ACA:
The ACA charges the Secretary of HHS with the creation of a rating system for qualified health plans offered through an Exchange. The Exchange must assign a quality rating to plans and provide this information to individuals and employers through its website. The relevant section is:
§1311 - Instructs the Secretary of HHS to develop a rating system that would rate qualified health plans based on quality and requires Exchanges to assign a rating to each qualified health plan offered in accordance with the Secretary’s criteria. Exchanges also must publish the quality ratings on their websites. Until guidance is issued, it is unclear how much discretion states may have in adding additional criteria.
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Does the plan submission deadline in the "State QHP certification Dates" chart refer to the deadline for binder submission with basic QHP information such as plan benefit design, cost-sharing characteristics, out-of-pocket expenses, pharmacy benefit plan data, etc?
District of Columbia
Hi Julia- the exact submission requirements will depend on the state, but we do use "plan" to mean at least the general plan benefit information. For more information, we have each state's RFP or other documentation linked in the chart.
District of Columbia
On November 20, 2012, HHS released a notice recognizing NCQA and URAC as the accrediting entities as part of QHP certification.
District of Columbia
This document covers in depth questions relevant to Exchange planning and implementation, identifying where the ACA provides guidance, where further guidance is needed and factors that need to be considered when making decisions around the Exchange structure. Access the document here: http://www.statereforum.org/sites/default/files/exchange_questions_sep_2...
District of Columbia
Senate Bill 38 was introduced in the NM legislature in 2011. It would establish the structure, governance, and duties of the Exchange.
Access the legislation here:
http://www.statereforum.org/sites/default/files/nm_sb0038.pdf
District of Columbia
These draft policy recommendations on an insurance Exchange were submitted to the OR Health Policy Board. Access the draft recommendations here: http://www.statereforum.org/sites/default/files/or_oha_expolicyrecs_0813...
District of Columbia
Senate Bill 99 was introduced in the Oregon Legislature in 2011. If enacted, it would define the structure and governance of the Exchange, specify the functions of the Exchange, outline who may purchase insurance through the Exchange, and establish a fund to support Exchange operations.
Access the legislation here:
http://www.statereforum.org/sites/default/files/relating_to_oregon_healt...
District of Columbia
This report discusses how the ACA will affect MA. The report finds that adjustments will be needed across a variety of dimensions despite many similarities between the state's 2006 reform legislation and national health reform. Access the report here: http://www.statereforum.org/sites/default/files/nhr_report_final.pdf
District of Columbia
The document is Tennessee's response to the HHS request for comments on insurance exchanges. Access the comments here: http://www.statereforum.org/sites/default/files/tennessee_comments.pdf
District of Columbia
This document requests stakeholder comments regarding areas where the ACA leaves states flexibility related to implementation and the Exchange. Access the document here:
http://www.statereforum.org/sites/default/files/exchangecomments_100803-...
District of Columbia
These comments are South Dakota's response to the HHS request for comments on insurance exchanges. Access the comments here:
http://www.statereforum.org/sites/default/files/south_dakota.pdf