May 24, 2013

May 24 Washington Update

Greetings from Washington, DC!  This update includes some information on upcoming webinars and other information on a variety of topics, including immigration reform, Medicaid managed- long-term care standards, and Exchange plans proposed by insurers. 

Our hearts go out to the people of Oklahoma suffering from the aftermath of the tornadoes.  The work of the Oklahoma F2F in reaching out to families is a great example of the value of F2Fs -- one that should surely be cited when we talk about the need to continue F2F funding. 


Online dialogue on transition issues.  As reported last week, from May 13-27, the U.S. Departments of Labor, Education, and Health and Human Services and the Social Security Administration are jointly hosting an event to get public feedback about the impact of existing federal regulations and legislation on the transition from school to work of youth and young adults with disabilities.  Policymakers, educators, service providers, families, youth, the advocacy community and others are invited to join this conversation to help the agencies identify  federal legislative and regulatory barriers regarding employment, education, Social Security, and health and human services.  To register and participate, go to

Webinar on health care innovation awards.   On Tuesday, May 28, 1:00 - 2:30 PM EDT, HHS will conduct a webinar to provide more information about the second round of the Health Care Innovation Awards announced last week by the CMS Innovation Center -- a $1 billion initiative to test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid and/or Children's Health Insurance Program (CHIP) enrollees.  More information, including a fact sheet and the Funding Opportunity Announcement, can be found at the Health Care Innovation Awards Round Two webpage. That page also links to a list and map of projects already underway from the earlier round so you can find out what is happening in your state.  Advanced registration is required for participation in the webinar. Register here.

Webinar on features of Qualified Health Plans.  On Wednesday, May 29th from 2:30-4:00 PM EDT, State Refor(u)m, will hold a webinar to explore the key elements -- benefit design, consumer protections, actuarial value, network adequacy, marketing requirements, accreditation, rates, and more -- of certifying health plans for participation in Exchnages.  Register here.

Webinar on Medicaid MLTSS Report.  On May 29, at 2 pm EDT, a webinar will be held to discuss a report on Medicaid MLTSS issued by The President's Committee for People with Intellectual Disabilities (PCPID).  The webinar is part of The Arc's HealthMeet Project and is sponsored by the Association of University Centers on Disabilities.  It will provide an overview of MLTSS, explain key issues for individuals with I/DD, and highlight recommendations contained in the report.  More information and a link to register can be found here.

Webinar on Health Insurance for Children and Youth with Special Health Care Needs.  Thursday, June 6, 11:00 AM - 12:00 PM EDT.  This webinar, hosted by the National Center for Ease of Use of Community-based Services, will provide information about eligibility for public and private health insurance for CYSHCN from immigrant families and explore the provisions of the Affordable Care Act aimed at removing barriers to care.  Register here.

Webinars on Health Insurance Marketplaces (Exchanges).  CMS has announced series of training webinars about Exchanges to be held in June and July.  There will be two levels, basic and advanced.  Space is limited, but the webinars are offered on multiple dates.  The schedule and registration links are at the end of this update.


CMS Guidance on Medicaid managed care for long-term services and supports (MLTTS).  On May 21, CMS issued an informational bulletin to announce the release of two important guidance documents on long-term services and supports delivered through Medicaid managed care programs: Summary of Managed Long Term Services and Supports Programs Essential Elements, and Guidance to States using 1115 demonstrations or 1915(b) waivers for Managed Long Term Services and Supports Programs.  CMS will use these principles when reviewing states' design, implementation, and operation of a Medicaid MLTSS program before approving that program, and on an ongoing basis to ensure program operation is consistent with the elements described in the guidance.  The new guidance documents and related information can be found on the CMS Medicaid MLTSS webpage.

Demonstration projects to improve prospects for children on SSI.  As reported in "Disability Scoop," on May 22, the federal government announced plans Tuesday to establish demonstration projects in a handful of states that would offer coordinated services and supports to promote better educational and career outcomes for SSI recipients ages 14 to 16.  Up to $10 million a year is available for five years to each state or team of states that's selected to participate in the new initiative known as Promoting Readiness of Minors in Supplemental Security Income, or PROMISE.

Pre-exiting Condition Insurance Plan rules.  On May 17, 2013, CMS issued a Pre-Existing Condition Insurance Plan (PCIP) Program Provider Payment rule.  Under the Affordable Care Act, this interim final rule adjusts pre-existing condition insurance plan provider rates to reduce the rate of program expenditures.  View the rule here and the latest enrollment and expenditure information for PCIP here.


Immigration Reform.  The health advocacy community is concerned about the health care provisions in the immigration reform measures currently being negotiated on Capitol Hill.  The Senate bill has been reported out of committee, but health-related amendments are expected when the bill reaches the Floor.  On the House side, negotiators have apparently reached an agreement under which provisional citizens will not be eligible for Medicaid or taxpayer subsidies to join health insurance exchanges, but could receive emergency care without the threat of deportation "as long as they pay the bill," according to Rep. Raúl R. Labrador (R-ID), who also said that provisional citizens would be mandated to provide their own insurance "on penalty of deportation."  Child health advocates are concerned that some children could lose public benefits if they seek a path to citizenship.  More information will follow as the situation unfolds.

F2F funding legislation.  There are no new cosponsors of the F2F funding bills sponsored by Senator Robert Menendez (D-NJ) (S. 423) and Representative Frank Pallone (D-NJ) (H.R. 564). The bills would extend funding for Family-to-Family Health Information Centers (F2Fs) through FY 2016 at the current funding level of $5 million per year.  The Family Voices policy team is communicating with Hill staff to strategize and identify potential vehicles through which the legislation might be enacted.  If you would like to urge your Representative and/or Senators to cosponsor these bills, you can find their contact information at


StateRefor(u)m:  Health insurance carriers are submitting their intent to offer plans on exchanges in many states, offering a first look at how those states' markets will take shape.  The submissions are not the final plan offerings; they are "rough drafts" that indicate how robust the market competition may be in each state. They also give a sense for which plans might be available to individuals and small businesses.  Read about the plan submissions received by the states listed below, and share any public information from your own state.

Colorado: Ten Carriers interested in the individual market, six carriers interested in SHOP
California: Thirteen carriers plan to offer insurance to individuals; SHOP plans to be announced in June
Washington: Received nine notifications of intent to participate from health and dental carriers
Connecticut: Nine carriers plan to offer health and dental coverage in the exchange
Maryland: Six medical and ten stand-alone dental plans to offer in the exchange
District of Columbia: Four Carriers submitted nearly 300 products

Information about health insurance affordability under the ACA.  There is a lot of speculation about the impact of the ACA on future health insurance costs.  Today's blog of the Center on Budget and Policy Priorities includes an article addressing that issue and concluding that insurers' proposals submitted to date indicate that the ACA's federally financed premium subsidies will help reduce what low- and moderate-income people will have to pay for coverage. 

More resources on ACA implementation:

FAQs on ACA issues.  CMS recently posted some new Marketplace Frequently Asked Questions (FAQs) about cost-sharing, premium tax credits, and other (rather technical) ACA-related issues.  View the FAQs here.  A summary of earlier FAQs, about cost-sharing limitations under the ACA, was published by the George Washington University/Robert Wood Johnson "Health Reform GPS" project.  View that article here

Webcast on engaging and enrolling uninsured individuals.  Available here is a webcast of a session held by Families USA and Enroll America that discusses: (1) tactics for successfully engaging uninsured people, particularly communities of color, to get them enrolled in health insurance, and (2) best practices for raising public awareness about the health insurance options available under the ACA. 

Families USA Resource Center on Navigators and In-Person Assisters.  Families USA has created a Navigator and In-Person Assister Resource Center and people can sign up to receive updates on this topic. 

Other websites where one can get information and sign up for updates are:

1. This site is geared towards consumers and provides general information about the Marketplace and health insurance. Consumers can sign up for email and/or text message updates.

2. This page has a wide variety of tools and resources to help you help people prepare to apply, enroll and get coverage in 2014. You can also sign up for updates by clicking on "Get updates." After entering your email address, check the box that says "Health Insurance Marketplace (Exchange)" under the "Outreach and Education" section near the middle of the page. This is the main avenue that CMS will use to communicate with interested stakeholders on Marketplace updates.

To submit comments or make inquiries, contact


As always, please feel free to contact us with any questions. 

Best, Janis & Brooke

Janis Guerney, Esq.

Brooke Lehmann, MSW, Esq.



CMS is happy to announce the availability of Health Insurance Marketplace webinars throughout the months of June and July.  These training opportunities are broken into two levels:


  • Level 1: Health Insurance Marketplace 101 (basic) - A one-hour high-level webinar overview of the accomplishments of the Affordable Care Act and a basic introduction to the Marketplace (Exchanges) highlighting who is eligible and how the Marketplace will work.


  • Level 2: Understanding the Health Insurance Marketplace (advanced) - A two-hour detailed review of the Marketplace (Exchanges), including eligibility, enrollment, plan structure, Medicaid expansion, and the streamlined application.


Please select the webinar that best suits your needs and then select the Registration Link that corresponds with the date to register for the webinar.  Please note that there is a limit of 200 people for each of the webinars and will be filled on a first come first serve basis; so we ask that you be flexible with your selected date.  However, more webinars will be added if demand is shown. The following tables list the available dates and times for the webinars:


Level 1: Health Insurance Marketplace 101



1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET


1:00 - 2:00 pm ET



Level 2: Understanding the Health Insurance Marketplace


1:00 - 3:00 pm ET


1:00 - 3:00 pm ET


1:00 - 3:00 pm ET


1:00 - 3:00 pm ET



For more information on these and other events hosted by the Centers for Medicare & Medicaid Services, email the CMS National Training Program at  Marketplace information and training materials for partners is available at