Affordable Care Act News: Navigator Final Rule Released

By Marilyn Tavenner

Cross-posted from

Marilyn TavennerOn July 15, 2013, the Centers for Medicare & Medicaid Services (CMS) took the next step in moving toward implementation of the Health Insurance Marketplaces by finalizing a proposed rule outlining the standards for Navigators, the in-person assisters in Federally-facilitated and State Partnership Marketplaces. The rule identifies training, conflict of interest standards, and standards for serving people with limited English proficiency and people with disabilities. (Read more about the Marketplaces.)

Millions of Americans will be eligible for new coverage opportunities through the Marketplaces beginning January 2014. Navigators will be available to provide un-biased assistance to consumers about health insurance, the new Health Insurance Marketplaces, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program (CHIP) as well as assist consumers in enrolling in coverage available through the Health Insurance Marketplaces. Continue reading

Increasing Flexibility for Ryan White Grantees Making 75/25 Core Medical Services Waiver Requests

Cross-posted from

Health Resources and Services Administration (HRSA)

Last week, HRSA published a Final Notice in the Federal Register, and invited comments, amending the uniform standards for requesting a core medical services waiver for fiscal year (FY) 2014 and beyond. This revision provides Ryan White grantees more flexibility in the timeframe for applying for waivers. The change in the standards will allow grantees to apply for a waiver at any time up to their annual Part A, B, or C application submission, at the same time as their annual Part A, B, or C application submission, or up to four months after their grant award for that funding year. It will also allow grantees to plan with certainty about the waiver and to make adjustments to their Ryan White Care funded systems in response to Affordable Care Act implementation in their areas. Continue reading

Gearing up for Open Enrollment: Accessing HIV/AIDS Care & Treatment through the ACA Marketplaces

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

Cross-posted from AIDS Education & Training Centers National Resource Center

By Amy Killelea, Senior Manager, Health Care Access, NASTADOctober 1, 2013 – the date when the Affordable Care Act’s (ACA’s) marketplaces open for enrollment – is less than four months away, and there is much still be done to ensure a smooth transition to coverage through these marketplaces.  The marketplaces, which will allow people to compare and purchase “Qualified Health Plans” (QHPs), provide a tremendous opportunity for people living with HIV to access comprehensive, affordable private insurance – many for the first time. Maximizing access to private insurance will be particularly important in states that do not expand Medicaid in 2014. However, engaging with and navigating the private insurance options will involve new issues and concerns and a new insurance vocabulary. Continue reading

The Future of Health Department HIV and Hepatitis Programs

By Dawn Fukuda, Director, Office of HIV/AIDS, Massachusetts Department of Public Health and NASTAD Chair (Incoming)

Dawn Fakuda

Dawn Fukuda, Director, Office of HIV/AIDS, Massachusetts Department of Public Health and NASTAD Chair

For perhaps the first time in history, the end of HIV/AIDS and hepatitis is within our reach. Recent notable achievements provide promise for success, among them the release of the National HIV/AIDS Strategy (NHAS) and the Viral Hepatitis Action Plan (VHAP) and the passage of the Affordable Care Act (ACA). Collectively, these achievements have catalyzed the beginning of a radical transformation in our healthcare systems for communities impacted by HIV and hepatitis. In particular, the ACA represents an opportunity for the country to expand access to HIV/AIDS and hepatitis prevention, medical care, and health promotion services in profound and impactful ways. The systems-level changes advanced in the legislation also require state health departments to reassess their role in the context of an evolving health care system and the other sources of financing that may become available to support what have historically been public health functions—this is particularly the case for HIV/AIDS and viral hepatitis prevention and care services. Continue reading

Sustaining HIV/AIDS and Viral Hepatitis Services: Leveraging Third-Party Reimbursement

By Liisa M. Randall, Consultant and Amy Killelea, Senior Manager, Health Care Access, NASTAD

Medical Bills by federal and state funding for HIV/AIDS and viral hepatitis services increasingly constrained, it is essential that health departments explore alternative sources of support to ensure the sustainability of vital services. Full implementation of the Affordable Care Act (ACA) provides new opportunities for health departments and implementing partners to leverage resources made available through third-party reimbursement. Please visit NASTAD’s health reform website for resources on what the ACA means for HIV/AIDS and viral hepatitis programs and services, and how health departments are preparing for reform. Continue reading