Tag Archive for Exchange

Health Insurance Exchange Deadline Extended

Today was supposed to be the deadline for states to tell the federal government whether they’d be building their own health insurance exchanges. But at the request of Republican governors, according to The New York Times, the Obama administration has extended the deadline nearly one month — to Dec. 14, 2012.

In a letter addressed to Virginia Gov. Robert McDonnell and Louisiana Gov. Bobby Jindal, who asked President Obama to move the deadline on behalf of the Republican Governors Association, Health and Human Services Secretary Kathleen Sebelius wrote, “We’re confident Governors will have enough time to decide whether they want to establish an Exchange, work in partnership with the federal government or have a federally-facilitated Exchange in their state.”

After states submit their applications to the federal government saying whether they want to run their own exchanges, Sebelius will have until Jan. 1, 2013 to decide which are capable of doing so, according to The Times.

Starting in October 2013, people will be able to enroll in health plans for coverage starting Jan. 1, 2014, which is when most Americans must have health insurance.

Photo of HHS Secretary Kathleen Sebelius courtesy of The White House.

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Eight States Awarded Health Insurance Exchange Grants

Eight states received funding to offer citizens and small businesses access to health insurance exchanges, the U.S. Department of Health and Human Services (HHS) announced Aug. 23. California, Hawaii, Iowa and New York were awarded Level One Exchange Establishment grants, which provide one year of funding to states that are in the starting stages of building an exchange. Connecticut, Maryland, Nevada and Vermont received Level Two grants, which are multiyear grants provided to states further along in the process of building an exchange.

Health insurance exchanges, which are one-stop marketplaces for comparing and selecting health insurance, are being created to support President Barack Obama’s recent law that requires every citizen to have health insurance. According to the HHS, access to these exchanges will be available in 2014, will provide access to “high-quality, affordable health insurance” and will provide citizens with “the same kinds of insurance choices as members of Congress.”

“We continue to support states as they move forward building an exchange that works for them,” HHS Secretary Kathleen Sebelius said. “Thanks to the health-care law, Americans will have more health insurance choices and the ability to compare insurance plans.”

A detailed breakdown of each grant and what each state plans to do with its exchange funding is available on Healthcare.gov.

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Hacking of Utah Health Insurance Exchange Raises Security Questions

With the news that the Utah health exchange — one of just two state-run online insurance marketplaces in operation — was recently hacked, states planning their own exchanges as prompted by the Affordable Care Act (ACA) might want to take a closer look at how they’ll handle cybersecurity.

The exchanges will hold digital records of a potential minefield of personal information — Social Security numbers, federal tax and income data and more. To gain approval from the U.S. Department of Health and Human Services (HHS) for their exchange, states must prove they meet five provisions related to privacy and security.

In short, the federal guidance for applications, which are due Nov. 16, requires that states provide “adequate safeguards” to protect personal information on the exchange. States must also secure a letter of acceptance from the IRS, affirming that they’re capable of protecting federal tax information, which will be used to determine eligibility for Medicaid and tax subsidies on the exchanges.

According to the exchange rules, “Personally identifiable information should be protected with reasonable operational, administrative, technical, and physical safeguards to ensure its confidentiality, integrity, and availability and to prevent unauthorized or inappropriate access, use, or disclosure.”

States must comply with the federal Health Insurance Portability and Accountability Act (HIPAA), as well as the standards set out in the ACA, but they do have significant leeway in how they meet those parameters.

For example, Rhode Island (which is viewed as a case study for exchange planning) will require the company building the digital infrastructure for its exchange to hire a security manager. The vendors must also purchase an insurance policy that would cover up to $1 million in damages for any security failure.

California, which sent out its request for proposals for the exchange in January, is requiring its vendors to sign a confidentiality agreement. Broadly speaking, the California outline for its exchange says that its software vendors “should leverage government, industry and federally funded academic research on security, privacy and continuity of operations, with a strong link to available and emerging products and solutions.”

California is also requiring that the exchange be able to verify users’ identities with state agencies, such as the Department of Motor Vehicles, before allowing them to access confidential information. The software must also include layered firewalls and data encryption to protect the data in the exchange.

Utah officials stressed that no personal information was at risk during the hacking, which took place three weeks ago, according to the Salt Lake Tribune. Only informational pages, which outline insurance options available to consumers, were affected. State officials portrayed the breach as a “pure act of graffiti. Words were garbled, headlines were blurred.”

It wasn’t the first time that the state’s health sector had been compromised. Back in April, the state’s Medicaid database was breached, with hackers gaining access to the Social Security numbers of as many as 280,000 Utah residents. Less sensitive information, such as names and birth dates, for about 500,000 others was also exposed, according to the Tribune.

With an increasing push to digitize medical information, data breaches are one of the risks. As Kaiser Health News reported in June, HHS has received more than 22,000 complaints about privacy violations since HIPAA was enacted in 2003. Some of the largest breaches (which usually involve private health-care providers) compromised the information of millions of individuals.

“Strong privacy and security rules are crucial to the success of the new health insurance exchanges,” wrote Kate Black of the Center for Democracy and Technology, a nonprofit that advocates for Internet freedom. “If adequate privacy rules and security safeguards do not protect the information collected by exchanges, individuals will not have sufficient trust in an exchange to take advantage of its benefits.”

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Maryland to Deploy Statewide Health Benefit Exchange in 2013

Maryland is slated to deploy a statewide health benefit exchange platform next October that will allow uninsured residents to determine their eligibility for health-care subsidies and tax credits and help them find an affordable health plan.

Maryland’s deployment a year from now is scheduled to meet deadlines surrounding the Affordable Care Act of 2010. The legislation mandates that U.S. citizens who meet the requirements outlined in the bill have health insurance or they will face a monetary penalty. The requirements will take effect in 2014.

In August, the U.S. Department of Health and Human Services collectively awarded $765 million in insurance exchange grants to eight states, including Maryland, to develop their platforms. Maryland, Connecticut, Nevada and Vermont received level-two grants, which were awarded to states that “have made more progress in their planning efforts,” according to Kaiser Health News.

Other states, including Washington, Massachusetts and New York have also established a state exchange. Other states are planning a partnership exchange, still studying options, or like Alaska, Louisiana and Maine, have decided not to create a state exchange, according to the Kaiser Family Foundation.

Maryland is contracting with IBM to roll out its benefit exchange, which will be called the Maryland Health Connection. The exchange will be operated on software by Curam, a company IBM acquired less than a year ago.

Once the platform is available, Maryland residents who don’t have health insurance will be able to use it essentially as an online marketplace to choose an insurance plan, said Ernie Connon, IBM’s vice president of health and human services industry solutions.

Within its first year of deployment, the exchange platform is expected to help more than 100,000 residents purchase health insurance and up to nearly 275,000 by 2020, according to IBM.

Because the federal government is still determining some of the rules regarding eligibility, Connon said the Maryland Health Connection platform is being developed to accommodate new rules as they are implemented. Final rules set by the federal government will determine how much an individual may have to pay out of pocket for health insurance, or if he or she will be subsidized or provided for under Medicaid.

“One of the things that we’re doing here is building a solution that allows for the dynamic change, so if the rules were to change over time, we can quickly adapt to that,” Connon said.

In addition to Maryland, IBM announced this summer that the company is developing a similar exchange platform for Minnesota as well as other states. Connon said for one such case, IBM hopes an exchange will create a user experience that individuals with eighth- to ninth-grade reading levels can quickly comprehend.

“You’re having people who are going to come to this application that are going to drive the online experience, but not have a user manual to help them through this,” Connon said. “This has got to be fairly self-explanatory; it’s basically got to help drive them through the whole experience.”

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