CMS Division of Tribal Affairs
Important Information for our Tribal partners
A new question and answer (Q&A) regarding the Special Enrollment Period for American Indian and Alaska Native families has been posted on healthcare.gov/tribal
The Q&A explains that for those families that apply through the Federal-facilitated Marketplace, if one family member on the application is eligible for the Special Enrollment Period (SEP), all family members who apply on the same Marketplace application would be eligible for the SEP if otherwise eligible to enroll in a QHP. The Q&A explains that for those who enroll in a state based marketplace, you will need to contact your state regarding whether this policy applies.
To read the Q&A, please visit healthcare.gov/tribal or
CMS Announces Opportunity to Apply for Navigator Grants in Federally-facilitated and State Partnership Marketplaces
“Navigator” program will continue to help consumers understand health coverage options as they enroll in coverage
The Centers for Medicare & Medicaid Services (CMS) today announced the availability of funding, totaling $60 million, to support Navigators in Federally-facilitated and State Partnership Marketplaces in 2014-2015. Navigators provide unbiased information to consumers about health insurance, the Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program.
“Navigators have been an important resource for the millions of Americans who enrolled in coverage in 2014. This funding ensures this work will continue next year, including during the open enrollment period for the Marketplaces,” said CMS Administrator Marilyn Tavenner.
The funding opportunity announcement is open to eligible individuals, as well as private and public entities, applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace. It is open to new and returning Navigator applicants, and applications are due by July 10, 2014.
Last month, CMS finalized regulations that update the requirements applicable to Navigators. To access the final rule, visit: https://www.federalregister.gov/articles/2014/05/27/2014-11657/patient-protection-and-affordable-care-act-exchange-and-insurance-market-standards-for-2015-and
Navigators will now be required to maintain a physical presence in the Marketplace service area, so that face-to-face assistance can be provided to consumers. Navigator grant applicants will also be encouraged to perform background checks for all Navigator staff that will be handling sensitive or personally identifiable information (PII). In addition to quarterly and annual reporting, Navigators will be required to submit to CMS weekly and monthly progress reports detailing their progress and activities in their target communities.
To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.332.
For more information about Navigators, visit: http://cciio.cms.gov/programs/exchanges/assistance.html
All Tribes Call
Redetermination and Renewal for Exchange Participation for 2015
Monday, July 21st 1- 2pm ET
Meeting Number: 991 676 757
(Follow instructions you hear on the phone, meeting ID not required: hit #)
CMS will be hosting an All Tribes’ Call on July 21, 2014 from 1 – 2 pm ET to obtain advice and input on proposed rules that were published regarding Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges.
On July 1, HHS announced plans for helping existing Marketplace consumers get auto- enrolled for next year. These plans would give existing consumers a simple way to remain in the same plan next year unless they want to shop for another plan and choose to make changes. Consumers always have the ability to return to the system for shopping, changing plans, or reporting life changes, or a change to their annual income to ensure they are getting the lowest cost possible on their monthly premium. And, in 2015, for those enrolled in a Federal facilitated Marketplace, the small number of consumers whose updated income information suggests they no longer qualify for a tax credit next year, will still be auto- enrolled in their current plan, but without a tax credit. State-based Marketplaces may take this approach as well, or propose an alternative.
Consumers in the Federally-facilitated Marketplace will receive notices from the Marketplace informing them how to update their information to get a tailored and updated tax credit that keeps up with any income changes. Consumers will receive information from their health insurance company about the premium and the amount they are eligible to save on their monthly bill close to the beginning of the open enrollment period, when they will be able to take action should they choose to do so.
The proposed rule is posted at the Federal Register and further guidance is posted on the CCIIO website. Written comments should be submitted per the Federal Register requirements.
Link to the (NPRM) Proposed Rule: http://www.gpo.gov/fdsys/pkg/FR-2014-07-01/pdf/2014-15362.pdf
Link to CCIIO's Guidance Letter: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Guidance-on-annual-redet-option-2015-6-26-14.pdf
Long Term Supports & Services Webinar
Using Data From the US Census Bureau to Learn More About Older American Indians and Alaska Natives:
Counts, Definitions, and Boundaries
Wednesday July 23, 2014; 2:00-3pm ET
- Joshua Coutts, Geographer, Geography Division, U.S. Census Bureau
- Timothy Gilbert, Survey Statistician, American Community Survey Office, U.S. Census Bureau
To join the webinar:
- Go to the Adobe Connect webinar.
- Select "Enter as a Guest."
- Type in your first and last name.
- Click "Enter Room."
- For audio, call 1-888-757-2790.
- Enter 177695 and then press #.
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- DTLL-2015-Health-Insurance-2-4-14 [PDF, 64KB]
- Navigator DTTL 4_10_2013 [PDF, 36KB]
- DTLL Tribal Consultation 022113 [PDF, 150KB]
- Tribal Leader Letter 12/5/12 [PDF, 89KB]
- ITU Addendum Tribal Leader Letter [PDF, 1MB]
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- CMS ICD-10 Industry Email Updates
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