The Assister Bulletin is a technical assistance resource funded under a grant from the  Health Resources Services Administration (HRSA), 
Bureau of Primary Health Care
for Florida Assisters  on the Health Insurance Marketplace.



~ SEPTEMBER 1, 2017 ~

IS THE CONSUMER ELIGIBLE FOR A
SPECIAL ENROLLMENT PERIOD?
https://www.healthcare.gov/screener/ 
 
 
MONTHLY LUNCH & LEARN CONFERENCE CALL 

     
Date 
Friday, Sept. 29th 2017  
Time 
12:30-1:30 PM  
Call # 
1-866-808-9981  
Code 
363988#  
 
 
 
 
Officials in Houston are just beginning to grapple with the health and environmental risks that lurk in the waters dumped by Hurricane Harvey, a toxic stew of chemicals, sewage, debris and waste that still floods much of the city. Flooded sewers are stoking fears of cholera, typhoid and other infectious diseases. Runoff from the city's sprawling petroleum and chemicals complex contains any number of hazardous compounds. Lead, arsenic and other toxic and carcinogenic elements may be leaching from some two dozen Superfund sites in the Houston area. New York Times 
 
A Trump administration official said Wednesday that the administration wanted to stabilize health insurance markets, but refused to say if the government would promote enrollment this fall under the Affordable Care Act or pay for the activities of counselors who help people sign up for coverage. The official also declined to say whether the administration would continue paying subsidies to insurance companies to compensate them for reducing deductibles and other out-of-pocket costs for low-income people. Without the subsidies, insurers say, they would sharply increase premiums.
 

The Centers for Medicare & Medicaid Services (CMS) has approved a five-year extension of Florida's Managed Medical Assistance (MMA) section 1115 demonstration that gives the state authority to operate a capitated Medicaid managed care program and a low-income pool (LIP) to provide continuing support for the safety net providers that furnish charity care to the uninsured. "This program gives Florida the ability to care for its most vulnerable and at-risk citizens. Its renewal also provides flexibility to use the funds in a way that meets the unique needs of the State while reducing burden by eliminating duplicative reporting and documentation requirements," said CMS Administrator Seema Verma. "This extension has a positive and direct impact on people's lives and their ability to access care. Florida's program offers an innovative and realistic pathway to tackling some of Medicaid's biggest challenges."
 
This demonstration equips the state with new tools to help it meet the following goals:
  • Provides necessary financial support to public teaching hospitals, children's hospitals, and other hospitals for the care they furnish to low-income uninsured Floridians; and
  • strengthens the breadth of access to and quality of providers participating in Florida's managed care program, including care provided by many Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC).
Click here for more information regarding the five-year extension of the Managed Medical Assistance section 1115 demonstration program in Florida.  
 
Florida health insurers are seeking double-digit rate hikes for 2018 Affordable Care Act coverage, but this week state regulators asked insurers to submit backup plans to raise premiums even higher next year because of uncertainty surrounding the future funding of subsidies that help low-income Americans pay their out-of-pocket costs. The Office of Insurance Regulation said insurers need to account for the potential elimination of the subsidies, whose future funding has become an increasingly complex political question. President Donald Trump has threatened to halt the payments, called cost-sharing reductions, in hopes of reviving congressional efforts to repeal and replace the health law known as Obamacare.  Miami Herald 
 
 
 
 
 
 
 
PLAN YEAR 2018 ANNUAL TRAINING MODULES
  1. Open Enrollment 2018 is from November 1, 2017 through December 15, 2017.
  2. The annual training modules for enrollment assisters is currently available at the MLMS training site. Completion is mandatory for Navigators, CAC and non-navigator personnel.
  3. The training includes mandatory and optional modules, as well as, non-certification modules. Be sure to enroll in the correct series!
  4. Access the CMS Enterprise Portal, accept the Terms & Conditions and log-in. Returning assisters use the same log-in information as before. Returning assisters may also be asked to create a new password. New assisters will need to set up an Enterprise account.
  5. New assisters will need to request access to FFM Training - Agents/Brokers/Assisters.
  6. A yellow MLMS button & pull down will appear on the left of the page.
  7. If necessary, update your contact information before clicking Next.
  8. Select the appropriate modules and complete testing, as indicated. For problems with the training modules contact the MLMS Help Desk. [There is no phone #. Responses often take 72 hours.]
  9. There is no need to repeat training modules if the system does not register them. Simply take a screen shot showing the results of each test and send your request for a Certificate of Completion to MLMS Help Desk.
  10. If you are a Certified Application Counselor, submit the Certificate of Completion to your organization Human Resources Dept. They will issue a signed Certified Application Counselor Certificate (valid for one year) and a CDO-CAC Agreement describing your program duties as a CAC. All documents are available in the CDO-CAC Welcome Packet.
  11. A copy of your Certificate of Training Completion, Certified Application Counselor Certificate and CDO-CAC Agreement should be kept in your personnel file.
CACs are certified by their employer and that certificate must be visible to consumers at all times. This is NOT the same as a Certificate of Training Completion.
 
Review MLMS FAQ for questions about the annual training modules. Further information may be found at   CMS Technical Assistance Resources. 
 
Be sure to post your contact information on the  2018 Florida Enrollment Assister Database.
  

   
 
 
HHS is soliciting written comments on the proposed framework for Healthy People 2030 developed by the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030. The framework includes the Healthy People 2030 vision, mission, foundational principles, plan of action, and overarching goals - and it will guide the selection and prioritization of objectives for Healthy People 2030. Submit comments on the proposed framework through Sept. 29.



 

 
 NAVIGATOR GRANTS REDUCED
 
The Department of Health and Human Services has announced that it is changing Navigator funding awards for the grant year beginning tomorrow 9/1/2017. This news comes only a day ahead of when FFM Navigator programs expected to receive this year's grant award amount. The new funding amount will now be based on the proportion of a grantee's number of consumers enrolled versus its stated enrollment goal for plan year 2017. Estimates suggest that the new award calculation will bring overall Navigator funding down to $36 million, compared to $63 million awarded last year, causing a potential decrease in the number of Navigators available to assist consumers with  enrollment.

For further details, click here for the full CMS Bulletin

 
 
Health Reform: Beyond the Basics is an initiative of the Center on Budget Policies & Priorities. They have announced the following preliminary Fall 2017 training webinars for enrollment assistance personnel:

9/19/2017 
Tax Credits 
9/21/2017 
Household Size & Income 
9/26/2017 
Plan Design & Selection 
9/28/2017 
Exemptions 
10/4/2017 
Immigrant Eligibility 
10/18/2017 
Preventing & Resolving DMI 
 
Click on the following link to see their informative SEP Reference Chart.
 
 
  We want to be sure the
Enrollment Assister database is current.
So, whether you are a CAC or a NAV
and d
id this before, please do it again.
 


My consumer is planning to move to Florida. She has Massachusetts health care now and was told that the ACA is based on the Massachusetts healthcare model. Her concern is, when a person dies can the state can come after the Massachusetts residents assets for all past medical expenses? She doesn't like that part of the health plan and it makes her hesitant to apply.
We may not have had this question before because your consumer doesn't have complete information. Yes, the ACA is patterned after the Massachusetts healthcare model. That doesn't mean that the ACA is completely the same or that the MA state plan is the same as the federally facilitated Marketplace we use in Florida. Your consumer will be eligible for a change of address SEP if she applies within 60 of relocating and if she proves her change of address. I can tell you from personal experience that neither state can recover healthcare expenses if there is an active insurance plan at that time. That's one of the things health insurance is for. However, they can recover taxpayer funded costs to which the consumer is not eligible. As an example, if my daughter had died with a $1M inheritance, the state of Florida could have recovered up to $1M because she should not have been a Medicaid beneficiary. But since she died as a disabled adult with no assets, she was eligible for Medicaid coverage and the state had nothing to recover.

I'm having difficulty re-setting my CMS password. Can you help me?
Unfortunately, this is not something I can facilitate. For challenges with the mandatory annual training, please contact MLMSHelpDesk@cms.hhs.gov

 
   

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