On July 17, 2013, CMS published a final rule to establish standards for “Navigators” in federally-facilitated and state partnership Affordable Insurance Exchanges under the ACA. Under prior CMS regulations, Exchanges must award grants to Navigators to provide impartial information to consumers about health insurance, the Exchange, Qualified Health Plans (QHPs), various insurance affordability programs, and grievance procedures, among other functions. The July 17, 2013 final rule establishes conflict-of-interest, training and certification, and meaningful access standards applicable to Navigators (and certain other non-Navigator assistance personnel funded through federal Exchange Establishment grants). State Exchanges have the option of using this guidance or developing their own. The rule also clarifies certain licensing and certification requirements and specifies that entities with relationships to issuers of stop loss insurance are ineligible to become Navigators. According to a CMS press release, grant awards for Navigators in states with federally-facilitated and state partnership Exchanges will be awarded on August 15, 2013.
Home Regulatory Developments Centers for Medicare & Medicaid Services Regulations CMS Finalizes ACA Health Insurance Exchange “Navigator” Standards