Patient Navigator Program Funding Announcement: Ensuring ACA Outreach and Enrollment Resources Reach People Living with HIV and Hepatitis

By Amy Killelea, Senior Manager, Health Care Access, NASTAD

State Decisions For Creating Health Insurance ExchangesOn April 9th, the Centers for Medicare and Medicaid Services (CMS) released a funding opportunity announcement (FOA) for eligible entities to serve as Patient Navigators in federally facilitated and partnership exchanges/marketplaces (state-run exchanges/marketplaces will be administering their own Patient Navigator programs). To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA #93.750. See the Kaiser Family Foundation map to the right to see which type of exchange/marketplace your state will have.

Upcoming Webinars on Patient Navigators

To learn more about the Patient Navigator FOA and what it takes to be a patient navigator, register for the webinars referenced below.

  • CMS, Conference Call on Patient Navigator FOA, April 19, 2013 (3:30-5:00pm EST)
 Toll-free teleconference phone number: 877-267-1577; ID: 2917
  • Enroll America, Webinar: So You Want to Be a Navigator? April 18, 2013 at 2:00pm EST. Register here.

What is the Patient Navigator Program?

The Patient Navigator program will fund eligible entities (including state health departments and community-based organizations) to conduct a range of outreach, education, and enrollment assistance activities to help people purchase insurance through the exchange/marketplace. Navigators must be able to serve both the individual exchange/marketplace as well as the Small Business Health Options Program (SHOP). However, applicants may identify the specific populations they will reach. For instance, an applicant could note expertise in serving underserved populations (such as low-income people living with HIV) or individuals with limited English proficiency.

Navigators are expected to:

  • conduct public education activities about insurance coverage options available through the exchange/marketplace;
  • provide information to applicants in a fair and impartial manner;
  • be knowledgeable about other health programs, such as Medicaid;
  • help applicants choose a Qualified Health Plan that meets their needs;
  • refer applicants to relevant appeals bodies to resolve complaints, etc.; and
  • provide information in a culturally and linguistically appropriate manner.

A proposed regulation currently out for comment provides additional information about the conflict-of-interest and training/certification requirements for all Patient Navigators (whether serving in a federally facilitated, partnership, or state exchange/marketplace). For example, Navigators must undergo thirty hours of training, receive a passing score on an approved certification examination, and participate in annual continuing education.

How Do I Apply to Become a Patient Navigator?

The funding opportunity provides up to $54 million in total funding to eligible entities. Applications are due by June 7, 2013 (applicants may submit an optional Letter of Intent by May 1, 2013). To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA #93.750. Applicants must have a Dun and Bradstreet Data Universal Numbering System (DUNS) number (any federal grantee will already have this number).

State HIV/AIDS programs and community-based organizations have the option of applying as a lead entity or applying as part of a consortium of applicants (with one designated lead entity). Smaller organizations may want to consider the consortium option and should identify and reach out to the other potential applicants in their areas.

Importantly, in addition to the Patient Navigator Program, there will be other outreach and enrollment resources and funding opportunities. Providers and state HIV/AIDS programs should monitor state Medicaid programs, departments of insurance, and exchange/marketplace websites for state training modules and other insurance assister opportunities.

Patient Navigator Resources

We want to hear from you! Do you or your organization plan on applying to be a Patient Navigator? Tell us by leaving a comment below.