State Health Reform Regulations
State agencies that administer public and private coverage programs, public health, and provider licensing will need to promulgate rules and regulations before they can implement some of the provisions of the ACA.
*Milestone details:
*Full name: Promulgate rules and regulations to make required changes consistent with state and federal law.
*Relevance to the ACA:
The work carried out by state agencies will rely on coherent rules and regulations to guide implementation actions. States are likely to need rules and regulations after new state laws are passed. States are also likely to need regulatory guidance to implement some ACA provisions that don’t require legislative updates. Given the variations in existing state agency responsibilities, and state administrative procedures, each state will need to comprehensively examine the ACA to identify areas where regulatory changes are needed. Some of the provisions likely to require regulatory action are:
§2702, §4302 – Update data reporting requirements to support quality measurement and better understand health disparities
§6201, §6401 – Update Medicaid and CHIP provider and supplier screening requirements to improve prevention of fraud, waste, and abuse
§1413, §2201 – Establish integrated enrollment systems among Medicaid, CHIP, and Exchanges
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District of Columbia
This report by the New York State Health Foundation details the challenges and opportunities NY faces in implementing reform, including Exchange, benefit design and payment issues. Access the report here: http://www.statereforum.org/sites/default/files/nyroadmappaper_aug2010.pdf