California Healthline: CMS Issues Final Rules for Open Enrollment Starting in 2015

On Friday, CMS issued a final rule outlining standards for the exchange and health insurance market beginning in the 2015 open enrollment period under the Affordable Care Act, including changes to how navigators are regulated and increases to risk corridor payments, Modern Healthcare reports.

Details on Navigator Guidelines

The guidelines reduce states’ abilities to regulate navigators by pre-empting state laws on such positions. According to the guidelines, CMS will pre-empt entire state laws, or parts of them, if they “prevent the application of the provisions of Title I of the” ACA. The agency said it is able to pre-empt the laws because “Congress made clear that while states continue to have authority to enact laws that affect programs established under the [ACA], that authority is not unlimited.”

Further, CMS specified that it would not pre-empt state laws that do not prohibit navigators from completing their federal duties, such as measures that require navigators to register, pass background checks or complete state training. However, CMS will pre-empt laws that require navigators to refer consumers to insurance brokers or agents for help with choosing an exchange plan.

Details on Risk Corridor Guidelines

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