More than just dafodils and tulips have emerged in recent weeks: new regs are out too! On March 12th CMS released final rules (with some interim sections) on exchanges, and then final eligibility regulations related to Medicaid and CHIP came March 16.

The exchange rule covered: establishment of exchanges, certification qualified health plans (QHPs), SHOP and the navigator program. In most cases, the final rule adopts the proposed rule with minor changes. The document emphasizes state exchanges and state flexibility, strengthens privacy standards, allows state Medicaid programs to determine final eligibility status and creates a role for web-based brokers in the enrollment process. Download the rule, and visit the State Refor(u)m blog to read about the rule's navigator provisions. Also check out Tennessee's new summary of the rule that includes a series of detailed clarifying questions for CCIIO and CMS.

The eligibility rule, according to CMS, maintains much of the framework laid out in the proposed rule, and includes improvements recommended by states, consumers, consumer organizations, and the healthcare provider community. Read the rule, download an impact analysis, see a chart comparing the proposed and final rule, or go straight to the fact sheet. Weigh in with reactions or a summary of your own.

Nevada: Eligibility Independent Verification and Validation RFP

This RFP notes that integrating the eligibility and enrollment processes across different publicly subsidized coverage programs, and helping them coordinate with the exchange, will be critical to providing an exchange that's truly a 'one-stop shop.' But like many states, Nevada has determined that their existing data system isn't up to the task. They've decided to create a single coordinated set of eligibility rules and a "rules engine" that will support Medicaid, CHIP, and exchange-based subsidy programs. Nevada seeks an independent consultant to assess the state's development and implementation plans for this undertaking. Read the background and scope of work of the RFP to compare your state's plans with Nevada's approach to such such a major project.

Oregon: Oregon Health Insurance Exchange Business Plan

The plan includes an operations timeline and addresses issues such as customer service and plan requirements. As part of an ongoing plan to ensure the exchange is self-sustaining beginning in 2015, the document lays out startup costs, staffing levels, and financial and enrollment projections. Some of these estimates and projections may be helpful for other states developing exchanges.

Oklahoma launched the first real-time Medicaid eligibility and enrollment system in the nation 18 months ago, and now State Refor(u)m's blog takes a look how it works, what the state has learned, what challenges remain. Use the comments section to ask a question about how Oklahoma got where there are.

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The recently released final exchange rule clarifies some expectations for the navigator programs that will will play a major role in the helping consumers choose health coverage in 2014 and beyond. One of our bloggers reads the regulations and notes the highlights.

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Implementing Health Reform in the States

March 27, 2:00 PM EDT
No registration required

To listen: log on to www.allhealth.org a few minutes before the webinar time.

This webinar will touch on everything from implications of the upcoming Supreme Court decision to Medicaid expansion to building health insurance exchanges

Edward Howard of the Alliance for Health Reform will moderate a conversation with:

• Enrique Martinez-Vidal of State Coverages Initiatives
• Matt Salo of the National Association of Medicaid Directors
• Noam Levy, writer for Los Angeles Times/Tribune, Washington bureau