Single Applications
Simplifying systems includes ensuring a simple and easy-to-navigate process for consumers seeking to enroll in state health subsidy programs. One streamlined application form for all programs simplifies the process for both consumers and the state.
*Milestone details:
*Full name: Develop a single application whereby people can apply for Medicaid, the basic health program, if adopted, CHIP, and federal tax credits through the Exchange.
*Relevance to the ACA:
The ACA requires the Secretary to establish a system in which people can apply and receive a determination of eligibility for state health insurance subsidy programs using a single, streamlined form. A state can adopt the form developed by the Secretary, or develop an alternative form. Provisions relevant to the development of a single application form include:
§1413 – Outlines the requirements for a single, streamlined form for all health insurance subsidy programs, and the exceptions that allow states to use supplemental forms. States can use a form being developed by HHS or develop an alternative form. The form must be:
-- Accepted online, in person, by mail, or by phone.
-- Accepted by the Exchange, Medicaid, and CHIP agencies.
-- Easy for applicants to complete.
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California
As Jocelyn Guyer's blog describes, the new single streamlined application improves on what was originally proposed. In general, it's shorter, which we have found in California to really make a difference for consumers. Like tax forms, it now offers an EZ version that is quite short, a version if you are not interested in financial assistance, and then a basic form (and even that is shorter). They've moved some of the material into appendices (for example, the form for an assister to identify that s/he has helped you), and put in more clear language on the cover sheets about what forms to use, etc. In some places they have made improvements in the language, taking feedback suggested by consumer advocates. We are also happy that two of the forms collect voluntary demographic information (though were disappointed that the application for those not seeking financial assistance doesn't collect that information). And, they developed some tools to help with complicated questions like health coverage through an employer. There are still some things advocates urged that didn't get incorporated, but overall we are moving in the right direction.
Colorado
Are you OK that there is no Employer application in the most recent set of paper apps? The 1/16/13 drafts had a separate SHOP application. Anyone know if that is being updated and will it be released soon?
Kansas
Has anyone reviewed the newly released app? Thoughts?
District of Columbia
There are a few thoughts on the new applications from Jocelyn Guyer on the Georgetown University Center for Children and Families blog:
Kansas
In light of the new policy brief posted on telephonic signatures, can anyone share informaiton about the state requirement to accept applications by phone?
I'm struggling to find any detail on this requirement.
Pennsylvania
Hi Allison -- The federal requirement for an Exchange to accept the single, streamlined application by telephone can be found at 45 CFR §155.405(c)(2)(ii). The corresponding requirement for the Medicaid agency is at 42 CFR §435.907(a)(ii), and is effective January 1, 2014.
That said, we are still waiting for specific sub-regulatory guidance from CMS regarding how States should design their telephonic application and signature processes. The Medicaid Final Rule from March 23, 2012 states that CMS “will be issuing subsequent guidance on this issue that permits States flexibility to design their telephonic application process.” Our best guess is that this guidance will be released shortly after CMS releases the final version of the single, streamlined application later this spring.
If you have additional questions, feel free to post here or contact me directly.
Pennsylvania
Benefits Data Trust recently partnered with Enroll America to develop this short policy brief to highlight the importance of telephonic signatures as a crucial technology solution to ensure a smooth application and enrollment process for those applying for health coverage over the phone. Successful implementation of telephonic signatures also has important implications for multi-benefit applications (e.g. SNAP, TANF, and IAPs).
District of Columbia
CMS is seeking public comment on the new single, streamlined application for health insurance and the SHOP applications in preparation for the launch of a new Health Insurance Marketplace next fall.
Video demonstrations are available at http://www.youtube.com/user/CMSHHSgov.
Attached are the:
-Individual Application: Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Affordable Insurance Exchanges, Medicaid and Children’s Health Insurance Program Agencies (CMS-10440)
-SHOP Employer: Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439)
-SHOP Employee: Data Collection to Support Eligibility Determinations and Enrollment for Employees in the Small Business Health Options Program (CMS-10438)
Arizona
Hi Kaitlin, Single streamlined application has a lot of confusing questions. Is there any resource available that I can refer to for better understanding of the set of questions in the single streamlined application.
District of Columbia
Hi Manish: Thanks for your question. CMS has two videos about the single, streamlined application, that may be helpful. You ou can view the videos here: http://www.youtube.com/user/CMSHHSgov. I have also attached a report from the Kaiser Family Foundation detailing some of the proposed elements of the application. If you have other specific questions, please feel free to post them here!
Arizona
Hi Kaitlin: Thanks for your quick response. Overall Section VI seems to be the most difficult to implement. Recently we were blocked at ques# 25 from section VI (Pg 17) of the document published by CMS. Here is the question:
25. (Display item if applicant list includes a person that isn’t listed as a tax filer or claimed as a tax dependent by anyone yet.)
How is [Next applicant FNLNS] related to [Household contact]?
[Dependent FNLNS] is the (Display relationship dropdown menu) of [Claiming tax filer FNLNS].
Are these two different questions included in one ?
Connecticut
The EMS system and Department of Social Services Modernization of Client Services Delivery project is intended to provide a single, web-based platform for application services.
District of Columbia
This piece walks through decision points regarding whether a state should implement a Basic Health program.
District of Columbia
This paper describes current state practices in offerring online applications.
Massachusetts
Massachusetts currently has a single "front door" application for most subsidized health coverage options in the state, including Medicaid, CHIP, and Commonwealth Care, a program offering subsidized insurance to those ineligible for Medicaid and CHIP benefits. Discussions are underway regarding the changes that need to be made to this application to encompass coverage types under the ACA.
Below is a link to the current Medical Benefit Request used in MA:
http://www.mass.gov/Eeohhs2/docs/masshealth/appforms/mbr.pdf
Applicants may also visit a hospital or community health center to submit an online "Virtual Gateway" application with the assistance of the hospital or community health center:
https://service.hhs.state.ma.us/ierhome/LandingPage.do?method=displayCon...
Attached is a presentation by Robin Callahan, Director of Member Policy and Program Development at the Massachusetts Office of Medicaid, wherein she describes the "one front door" to subsidized insurance in MA.
California
This RFP will be used to select a vendor to supply new Medicaid eligibility determination software.
Access the RFP here:
http://www.statereforum.org/sites/default/files/ks_rfp.pdf
District of Columbia
This paper outlines some key tools states can use to help consumers use Exchanges. Access the report here: http://www.statereforum.org/sites/default/files/consumerexperience.pdf
District of Columbia
This report provides an overview of the major provisions in the ACA, how they relate to Nevada, and outlines some key considerations for exchange governance, structure, and purchasing authority, and a proposed “Eligibility Engine” that would centralize eligibility for the state’s health coverage programs. Access the report here:
http://www.statereforum.org/sites/default/files/major_provisions_of_the_...
California
This report discusses Nevada’s proposed “Eligibility Engine” that would centralize the state’s eligibility determination functions for its coverage programs. The report includes an assessment of the current environment, how the Engine would function under the ACA, and recommendations for moving forward. Access the report here: http://www.statereforum.org/sites/default/files/establishment_of_an_elig...
California
On January 23, 2012, the Nevada State Purchasing Division, on behalf of the Nevada Department of Health and Human Services (DHHS), Division of Welfare and Supportive Services (DWSS) issued an RFP seeking proposals from qualified vendors to provide Independent Verification and Validation Services (IV&V) related to the design, development and implementation (DD&I) of the Health Care Reform Eligibility Engine. Currently, Nevada operates two separate and distinct eligibility systems to determine eligibility for its Medicaid Program and its CHIP Program (known as Nevada Check Up). The deadline for submission of proposals is no later than 2:00 pm on February 29, 2012 and a vendor selection is anticipated by March 13, 2012.
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