May 29, 2015



In This Issue
Exchanging Ideas
Limited Circumstances
Congress and the Courts
Medicare OEP Restoration Bill Headed for a Markup!
New Rules on Medicaid Managed Care
Calling All Wellness Nerds
HUPAC Round Up
What We’re Reading
E-mail the Editor
Visit the NAHU Website
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Exchanging Ideas

On Thursday, May 28, NAHU staff met with CEO Kevin Counihan to share suggested improvements to the federal exchange. We have an ongoing list of our “asks,” which have been supported by members of Congress on a bipartisan basis, and this meeting was an opportunity for us to underscore those concerns as well as propose more specific improvements to the system. In preparation for the meeting, NAHU’s Exchange Coordinators Working Group, which is made up of state chapter appointed representatives from every state who are engaged in exchange marketplace issues, discussed improvements to the federal exchange. These discussions culminated into a letter that was provided to Counihan prior to our meeting outlining ongoing requests as well as the additional enhancements we would like within the federal exchange.

There was overall agreement that the items on both lists were all areas that needed improvement over the next few years. Counihan described their progress on the federal exchange as a “five-year build” with improvements being installed each year. We spent a considerable amount of time discussing our request for an agent “hotline” or “concierge line” to address escalated enrollment issues that agents are encountering. Although there were no promises to implement this for the next open enrollment period, as all of the priorities for open enrollment 2016 have not been finalized yet, there was a better understanding of our request and the need for such a service, not just for agents and brokers, but for all in-person assistors.

An area we should see improvement in later this year is the “find local help” feature on This past year agents were listed separately in the system and weren’t automatically included in the list. They had to be selected separately to appear in the search. This is an ongoing project for the Centers of Medicare and Medicaid Services (CMS), and they are working on developing a search feature for the next open enrollment period that will provide separate tabs for each type of in-person assistors that will appear across the top of the screen and resolve the current issue with the search feature. CMS is also finalizing additional consumer and agent tools to better display cost-sharing requirements, provider networks and formularies, all items on our request list.

Another NAHU-suggested improvement they are working on that may not be ready by open enrollment in 2016, but perhaps by 2017, is to enable an editing feature to the online applications. Several problems are systemic from the inability to edit an application without revisiting each portion of the application, and CMS has recognized this problem and are working to create a system in which the applications can easily be edited or updated. They also have great recognition of the need to record the identifying number of all professionals that help exchange consumers each time they provide such assistance as a consumer protection and the need to allow agents to identify one NPN number for payment and potentially another to identify the agent providing the service.

CMS announced a new focus on developing a program to promote year round service on the exchange, and we believe this will be an opportunity to integrate the services that agents and brokers already provide to their clients throughout the plan year. CMS was very interested in working with NAHU on this item and also encouraged more interaction with NAHU throughout the year to continue to check in on the needs of agents and brokers since you all experience the day to day workings of the exchange systems. As improvements are made to the federal exchange we here at the Washington Update will be sure to let you know!

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