Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (CMS-2334-P2)

171 organizations filed 180 public comments on Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (CMS-2334-P2), at the Centers for Medicare & Medicaid Services. The comment window closed 3466d ago.

Abstract

This proposed rule would implement provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act), and the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This proposed rule reflects new statutory eligibility provisions; proposes changes to provide states more flexibility to coordinate Medicaid and the Children’s Health Insurance Program (CHIP) eligibility notices, appeals, and other related administrative procedures with similar procedures used by other health coverage programs authorized under the Affordable Care Act; modernizes and streamlines existing rules, eliminates obsolete rules, and updates provisions to reflect Medicaid eligibility pathways; revises the rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; implements other CHIPRA eligibility-related provisions, including eligibility for newborns whose mothers were eligible for and receiving Medicaid or CHIP coverage at the time of birth; amends certain provisions included in the “State Flexibility for Medicaid Benefit Packages” final rule published on April 30, 2010; and implements specific provisions including eligibility appeals, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also proposes to update and simplify the complex Medicaid premiums and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities.

Commenters (171)

• DC - National Association of Medicaid Directorstrade assoc.

  3 filings · confidence 85%
• DC--Planned Parenthood Federation of Americatrade assoc.

  3 filings · confidence 85%
• American Academy of Pediatrics (AAP)

  2 filings · confidence 97%
• DC--American Public Human Services Associationtrade assoc.

  2 filings · confidence 85%
• DC--Diverse Elders Coalitiontrade assoc.

  2 filings · confidence 85%
• IL--HIV Prevention Justice Alliancetrade assoc.

  2 filings · confidence 85%
• MD--The Annie E. Casey Foundationtrade assoc.

  2 filings · confidence 85%
• American Apparel & Footwear Associationtrade assoc.

  1 filing · confidence 97%
• American Association on Heath and Disabilitytrade assoc.

  1 filing · confidence 85%
• American Federation of Statetrade assoc.

  1 filing · confidence 85%
• American Health Care Association (AHCA/NCAL)trade assoc.

  1 filing · confidence 97%
• American Hospital Associationtrade assoc.

  1 filing · confidence 85%
• American Medical Associationtrade assoc.

  1 filing · confidence 97%
• Association of Asian Pacific Community Health Organizationstrade assoc.

  1 filing · confidence 85%
• CA - California Association of Public Hospitals and Health Systemstrade assoc.

  1 filing · confidence 85%
• CA--Alliance for Children's Rightstrade assoc.

  1 filing · confidence 85%
• CA--Asian Law Alliancetrade assoc.

  1 filing · confidence 85%
• CA--California Children's Hospital Associationtrade assoc.

  1 filing · confidence 85%
• CA--California Council of Churches IMPACTtrade assoc.

  1 filing · confidence 85%
• CA--California Medical Associationtrade assoc.

  1 filing · confidence 85%
• CA--California Mental Health Directors Associationtrade assoc.

  1 filing · confidence 85%
• CA--California Primary Care Associationtrade assoc.

  1 filing · confidence 85%
• CA--Children's Advocacy Institutetrade assoc.

  1 filing · confidence 85%
• CA--Coalition for Humane Immigrant Rights of Los Angelestrade assoc.

  1 filing · confidence 85%
• CA--County Alcohol and Drug Program Administrators Association of Californiatrade assoc.

  1 filing · confidence 85%
• CA--County Welfare Directors Association of Californiatrade assoc.

  1 filing · confidence 85%
• CA--Institute on Agingtrade assoc.

  1 filing · confidence 85%
• CA--Law Foundation of Silicon Valleytrade assoc.

  1 filing · confidence 85%
• CA--National Viral Hepatitis Roundtabletrade assoc.

  1 filing · confidence 85%
• CA--State Council on Developmental Disabilitiestrade assoc.

  1 filing · confidence 85%
• CA--The Children's Partnershiptrade assoc.

  1 filing · confidence 85%
• Celtic Insurance Companyunverified attribution

  1 filing · confidence 70%
• Community Partnership for Improved Long Term Caretrade assoc.

  1 filing · confidence 85%
• Consumers Unionunverified attribution

  1 filing · confidence 70%
• DC - American Thoracic Societytrade assoc.

  1 filing · confidence 85%
• DC - National Association of Public Hospitals and Health Systemstrade assoc.

  1 filing · confidence 85%
• DC--Alliance of Community Health Planstrade assoc.

  1 filing · confidence 85%
• DC--American Association of Nurse Anesthetiststrade assoc.

  1 filing · confidence 85%
• DC--American Association of University Womentrade assoc.

  1 filing · confidence 85%
• DC--American Federation of Teacherstrade assoc.

  1 filing · confidence 85%
• DC--American Heart Associationtrade assoc.

  1 filing · confidence 85%
• DC--American Lung Associationtrade assoc.

  1 filing · confidence 85%
• DC--American Osteopathic Associationtrade assoc.

  1 filing · confidence 85%
• DC--Association for Community Affiliated Planstrade assoc.

  1 filing · confidence 85%
• DC--Association of American Medical Collegestrade assoc.

  1 filing · confidence 85%
• DC--California Hospital Associationtrade assoc.

  1 filing · confidence 85%
• DC--Cancer Leadership Counciltrade assoc.

  1 filing · confidence 85%
• DC--Coalition for Whole Healthtrade assoc.

  1 filing · confidence 85%
• DC--Employers for Flexibility in Health Care Coalitiontrade assoc.

  1 filing · confidence 85%
• DC--Federation of American Hospitalstrade assoc.

  1 filing · confidence 85%
• DC--George Washington Universityunverified attribution

  1 filing · confidence 70%
• DC--Habilitation Benefits Coalitiontrade assoc.

  1 filing · confidence 85%
• DC--Huntington's Disease Society of Americatrade assoc.

  1 filing · confidence 85%
• DC--IHRSA: International Health Racquet & Sportsclub Associationtrade assoc.

  1 filing · confidence 85%
• DC--IHS Tribal Self-Governance Advisory Committeetrade assoc.

  1 filing · confidence 85%
• DC--League of United Latin American Citizenstrade assoc.

  1 filing · confidence 85%
• DC--Leukemia & Lymphoma Societytrade assoc.

  1 filing · confidence 85%
• DC--National Alliance of State & Territorial AIDS Directorstrade assoc.

  1 filing · confidence 85%
• DC--National Alliance to End Homelessnesstrade assoc.

  1 filing · confidence 85%
• DC--National Association of Community Health Centerstrade assoc.

  1 filing · confidence 85%
• DC--National Association of Councils on Developmentaltrade assoc.

  1 filing · confidence 85%
• DC--National Association of State Alcohol and Drug Abuse Directorstrade assoc.

  1 filing · confidence 85%
• DC--National Council for Community Behavioral Healthcaretrade assoc.

  1 filing · confidence 85%
• DC--National Council of La Razatrade assoc.

  1 filing · confidence 85%
• DC--National Council on Agingtrade assoc.

  1 filing · confidence 85%
• DC--National Education Associationtrade assoc.

  1 filing · confidence 85%
• DC--National Family Planning & Reproductive Health Associationtrade assoc.

  1 filing · confidence 85%
• DC--National Health Counciltrade assoc.

  1 filing · confidence 85%
• DC--National Latina Institute for Reproductive Healthtrade assoc.

  1 filing · confidence 85%
• DC--National Patient Advocate Foundationtrade assoc.

  1 filing · confidence 85%
• DC--Orthotic & Prosthetic Alliancetrade assoc.

  1 filing · confidence 85%
• DC--Pharmaceutical Care Management Associationtrade assoc.

  1 filing · confidence 85%
• DC--The AIDS Institute - "I Am Essential" Coalitiontrade assoc.

  1 filing · confidence 85%
• DC--The Catholic Health Association of the United Statestrade assoc.

  1 filing · confidence 85%
• DC--The Child Welfare League of Americatrade assoc.

  1 filing · confidence 85%
• DC--The National Alliance to Advance Adolescent Healthtrade assoc.

  1 filing · confidence 85%
• DC-American Medical Rehabilitation Providers Associationtrade assoc.

  1 filing · confidence 85%
• DC-Georgetown University Center for Children and Familiesunverified attribution

  1 filing · confidence 70%
• DC-National Association of Psychiatric Health Systemstrade assoc.

  1 filing · confidence 85%
• DC-National Association of Social Workerstrade assoc.

  1 filing · confidence 85%
• DC-TFAH on Behalf of a Coalition of Supportive Organizationstrade assoc.

  1 filing · confidence 85%
• Doctors Council SEIUtrade assoc.

  1 filing · confidence 85%
• FL--Adventist Health Policy Associationtrade assoc.

  1 filing · confidence 85%
• FL--Florida Association of Children's Hospitalstrade assoc.

  1 filing · confidence 85%
• FL--Health Rights Clinic of the University of Miami School of Lawunverified attribution

  1 filing · confidence 70%
• FL--National Association of Addiction Treatment Providerstrade assoc.

  1 filing · confidence 85%
• Franciscan Ministries--Marian Park Incunverified attribution

  1 filing · confidence 70%
• Huntington's Disease Society of Americatrade assoc.

  1 filing · confidence 85%
• IA--Iowa Behavioral Health Associationtrade assoc.

  1 filing · confidence 85%
• IL--AFSCME Council 31trade assoc.

  1 filing · confidence 85%
• IL--Children's Home + Aid Society of Illinoistrade assoc.

  1 filing · confidence 85%
• IL--Gateway Foundationtrade assoc.

  1 filing · confidence 85%
• IL--Huntingtons' Disease Society of Americatrade assoc.

  1 filing · confidence 85%
• IL--IL Association of Long Term Care Ombudsmantrade assoc.

  1 filing · confidence 85%
• IL--Illinois Alcoholism & Drug Dependence Associationtrade assoc.

  1 filing · confidence 85%
• IL--Illinois Association for Medication Assisted Addiction Treatmenttrade assoc.

  1 filing · confidence 85%
• IL--Illinois Association of Rehabilitation Facilitiestrade assoc.

  1 filing · confidence 85%
• IL--The Retirement Research Foundationtrade assoc.

  1 filing · confidence 85%
• IL-AIDS Foundation of Chicagotrade assoc.

  1 filing · confidence 85%
• IL-TASC Inc.unverified attribution

  1 filing · confidence 70%
• IN--Muncie Delaware County Council for People with Disabilities-Chairtrade assoc.

  1 filing · confidence 85%
• Inc. and Lundbeckunverified attribution

  1 filing · confidence 70%
• Inc. of Philadelphiaunverified attribution

  1 filing · confidence 70%
• MA--Family Equality Counciltrade assoc.

  1 filing · confidence 85%
• MA--MA Association of Older Americanstrade assoc.

  1 filing · confidence 85%
• MA--National Brain Tumor Societytrade assoc.

  1 filing · confidence 85%
• MA--The Massachusetts Immigrant and Refugee Advocacy Coalitiontrade assoc.

  1 filing · confidence 85%
• MA-Association for Behavioral Healthcaretrade assoc.

  1 filing · confidence 85%
• Maryland Women's Coalition for Health Care Reformtrade assoc.

  1 filing · confidence 85%
• Massachusetts Law Reform Institutetrade assoc.

  1 filing · confidence 85%
• MD--AFSCME Council 3trade assoc.

  1 filing · confidence 85%
• MD--American Occupational Therapy Associationtrade assoc.

  1 filing · confidence 85%
• MD--American Society of Addiction Medicinetrade assoc.

  1 filing · confidence 85%
• MD--Cystic Fibrosis Foundationtrade assoc.

  1 filing · confidence 85%
• MD--Epilepsy Foundationtrade assoc.

  1 filing · confidence 85%
• MD-National Health Care for the Homeless Counciltrade assoc.

  1 filing · confidence 85%
• MI--University of Michiganunverified attribution

  1 filing · confidence 70%
• MI--Washtenaw Interfaith Coalition for Immigrant Rightstrade assoc.

  1 filing · confidence 85%
• MN--MN Council of Health Planstrade assoc.

  1 filing · confidence 85%
• MO--MO Alliance for Home Caretrade assoc.

  1 filing · confidence 85%
• National Association for Home Care & Hospicetrade assoc.

  1 filing · confidence 85%
• National Association of Area Agencies on Agingtrade assoc.

  1 filing · confidence 85%
• National Association of Chain Drug Storestrade assoc.

  1 filing · confidence 97%
• National Community Pharmacists Associationtrade assoc.

  1 filing · confidence 97%
• National Coordinating Committee for Multiemployer Planstrade assoc.

  1 filing · confidence 85%
• NC--Tia Hart Community Recovery Program Inc.unverified attribution

  1 filing · confidence 70%
• NC-Durham County Nursing Home Advisory Committeetrade assoc.

  1 filing · confidence 85%
• NJ-Robert Wood Johnson Foundationtrade assoc.

  1 filing · confidence 85%
• NY--African Services Committeetrade assoc.

  1 filing · confidence 85%
• NY--Albany Affiliate of the Huntington's Disease Society of Americatrade assoc.

  1 filing · confidence 85%
• NY--Alzheimer's Foundation of Americatrade assoc.

  1 filing · confidence 85%
• NY--National Hemophilia Foundationtrade assoc.

  1 filing · confidence 85%
• NY--National Multiple Sclerosis Societytrade assoc.

  1 filing · confidence 85%
• NY--Public Employees Federationtrade assoc.

  1 filing · confidence 85%
• NY-National Kidney Foundationtrade assoc.

  1 filing · confidence 85%
• OH--AFSCME Ohio Council 8trade assoc.

  1 filing · confidence 85%
• OH--Ohio Association of Area Agencies on Agingtrade assoc.

  1 filing · confidence 85%
• PA--AFSCME District Council 88trade assoc.

  1 filing · confidence 85%
• PA--PA Homecare Associationtrade assoc.

  1 filing · confidence 85%
• PA--The Hospital and Healthsystem Association of Pennsylvaniatrade assoc.

  1 filing · confidence 85%
• Pennsylvania Department Of Public Welfare/Office of Income Maintenance/Bureau of Policyunverified attribution

  1 filing · confidence 70%
• The Hemophilia Alliancetrade assoc.

  1 filing · confidence 85%
• The Legal Aid Society of Columbustrade assoc.

  1 filing · confidence 85%
• The Retirement Research Foundationtrade assoc.

  1 filing · confidence 85%
• The San Diego IHSS Coalitiontrade assoc.

  1 filing · confidence 85%
• TN--Legal Aid Society of Middle Tennessee and the Cumberlandstrade assoc.

  1 filing · confidence 85%
• TX--Children's Hospital Association of Texastrade assoc.

  1 filing · confidence 85%
• VA--American Apparel & Footwear Associationtrade assoc.

  1 filing · confidence 85%
• VA--American Diabetes Associationtrade assoc.

  1 filing · confidence 85%
• VA--American Society of Transplant Surgeonstrade assoc.

  1 filing · confidence 85%
• VA--Children's Hospital Associationtrade assoc.

  1 filing · confidence 85%
• VA--Coalition for Disability Health Equitytrade assoc.

  1 filing · confidence 85%
• VA--Emergency Department Practice Management Associationtrade assoc.

  1 filing · confidence 85%
• VA--HIV Medicine Associationtrade assoc.

  1 filing · confidence 85%
• VA--IDEA Infant Toddler Coordinators Associationtrade assoc.

  1 filing · confidence 85%
• VA--National Alliance on Mental Illnesstrade assoc.

  1 filing · confidence 85%
• VA--National Association of State Mental Health Program Directorstrade assoc.

  1 filing · confidence 85%
• VA--National Community Pharmacists Associationtrade assoc.

  1 filing · confidence 85%
• VA--The American Physical Therapy Associationtrade assoc.

  1 filing · confidence 85%
• VA--the Brain Injury Association of Americatrade assoc.

  1 filing · confidence 85%
• VA-American Optometric Associationtrade assoc.

  1 filing · confidence 85%
• VA-American Psychiatric Associationtrade assoc.

  1 filing · confidence 85%
• WA--Alliance for a Just Societytrade assoc.

  1 filing · confidence 85%
• WA--Association of Alcoholism and Addiction Programs of Washington Statetrade assoc.

  1 filing · confidence 85%
• WA--United Spinal Associationtrade assoc.

  1 filing · confidence 85%
• WA--Washington Association of Community & Migrant Health Centerstrade assoc.

  1 filing · confidence 85%
• WA-Children's Home Society of Washingtontrade assoc.

  1 filing · confidence 85%
• WA-Washington Federation of State Employeestrade assoc.

  1 filing · confidence 85%
• WI--Wisconsin Alliance for Women's Healthtrade assoc.

  1 filing · confidence 85%
• WI--Wisconsin Council on Children and Familiestrade assoc.

  1 filing · confidence 85%
• WI--Wisconsin Hospital Associationtrade assoc.

  1 filing · confidence 85%