New York has received six grant awards to build its Health Insurance Marketplace - Opens in a new window . This includes a Planning Grant, an Early Innovator Grant, three Level One Establishment Grants and a Level Two Establishment Grant.
Summaries of New York’s applications for each grant are provided below:
Administrator: New York State Department of Health
Award Amount: $185,822,357
Award Date: January 17, 2013
Application Due Date: November 15, 2012
Award Supplement: $ 41,048,858 (September 20, 2013)
Level of Funding: Level Two
Summary: New York is receiving a Level Two Establishment Grant to support outreach and marketing, In-Person Assisters training and certification, and stakeholder engagement activities. New York will use funds to develop and operate the Call Center and back-end eligibility operations, make enhancements to the System for Electronic Rate and Form Filing (SERFF), and support costs for existing and new staff in 2013 and 2014. New York will purchase and maintain an accounting system for the marketplace (Exchange), will use funds for financial and operational audits, simulation modeling, and program evaluation. Funds will be used to pay for the balance of the marketplace IT system design and development costs including IT consultants and privacy and security consultants.
Administrator: New York State Department of Health
Award Amount: $10,774,898; $48,474,819; $95,496,490; $82,188,253
Award Date: August 12, 2011; February 22, 2012; August 23, 2012; May 2, 2014
Application Due Date: June 30, 2011; December 30, 2011; June 29, 2012; February 14, 2014
Level of Funding: Level One
Award Supplement: $ 19,016,553 (September 20, 2013)
Summary: New York has made significant progress under its exchange planning grant, early innovator grant, and consumer assistance program grant. This funding will: support background research; seek stakeholder input through a series of policy discussions focused on Exchange design and operation options; fund IT Systems; expand the capacity of its consumer assistance to serve the needs of small businesses, to expand assistance to individuals in regions of the State that currently have limited in-person access and expand consumer assistance with commercial insurance issues. The proposal also requests funding for key staff to begin the process of implementing the Exchange around governance.
With this second Level One grant, New York will continue its preparations to demonstrate operational readiness as required under the proposed Exchange Certification process. New York will use funding to develop and deliver an operationally-ready New York Health Benefit Exchange IT system; integrate services, functions, processes and systems across state agencies with the Exchange; establish New York’s All Payer Database which will be an integral component of the Exchange’s quality rating process and risk adjustment methodology; provide the actuarial work for New York-specific risk adjustment methodology; and complete new analyses and refine existing studies. New York’s grant will also maintain key Exchange planning staff and help build the services for work in the areas of Exchange eligibility and enrollment; customer assistance, complaints and appeals; certification of quality health plans; and the SHOP Exchange.
New York will use its third Level One Establishment Grant to hire executive leadership to: (1) further operationalize the Exchange to; (2) further enhance the IT Systems needed to operate the Exchange; (3) continue activities around the establishment of New York’s All Payer Claims Database; (4) develop the back-end operations of the Exchange Call Center and overall strategy to provide customer support and other consumer assistance activities; and (5) begin researching a campaign to educate enrollees in preparation for open enrollment in October 2013.
New York’s fourth Level One Establishment Grant will support a series of information technology system development needs. In addition, funding will support a significant increase in Customer Service Center and Eligibility and Enrollment staff and the associated rent and equipment needs to support these staff. Lastly, funding will support the Consumer Health Advocates program in 2014. The program is a network of 18 agencies which provide on-the-ground assistance to consumers in the communities where they live and work. Funding would be utilized to inform and educate consumers about appeal rights for services through commercial health plans; help empower consumers to be able to access their health coverage and be their own advocates; and providing feedback to stakeholders. The contract would be able to serve approximately 16,000-22,000 consumers.
Grantee: New York Department of Health
Award Amount: $27,431,432
Summary: New York proposes to build off its eMedNY Medicaid Management Information System (MMIS) system to build products for the Exchange. The eMedNY Medicaid Management Information System (MMIS) processes payments for approximately one of every three health care dollars paid in the state. It is also the primary source of Medicaid data used for financial reporting, program analysis, auditing, and quality measurement. The Department plans to use MMIS’ assets as the basis for designing and developing an Exchange to serve all New York State health insurance consumers. This approach will also result in the development of Exchange IT components fully extensible and scalable to any other jurisdiction.
Awarded September 30, 2010
Administrator: New York Department of Insurance
Amount Awarded: $1,000,000