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Wednesday, Sep 23 2015

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State Officials Find Deficiencies In N.Y. Health Marketplace Controls

Controls that New York used to screen insurance applicants for coverage and subsidies were deficient, a state audit found. Also in the news are developments in Vermont and Washington state.

Some controls New York state relied on to make sure people were eligible for health-insurance coverage and subsidies on the state-run exchange were deficient, potentially letting some consumers get benefits they weren鈥檛 entitled to, an audit found. The inspector general for the Department of Health and Human Services reviewed a sample of 45 randomly selected applicants and analyzed their supporting documentation to see if the New York exchange followed federal regulations in determining eligibility for coverage and subsidies. (Armour, 9/23)

Vermont officials said Tuesday they're cautiously optimistic the state's health insurance exchange will meet next week's deadline for smooth operations. State officials had promised in the spring that Vermont Health Connect would meet key benchmarks by Oct. 1, ahead of the Nov. 1 start to an open-enrollment period when new customers can sign up for health coverage through the exchange. (Gram, 9/22)

There have been weeks, even months, of warnings and notices, but starting Thursday, the 155,000 people enrolled in the Washington Health Benefit Exchange (WHBE) must pay their insurance companies directly instead of sending premiums to the state-run program. 鈥淎fter Wednesday at 5 p.m., we鈥檒l no longer be aggregating premiums or accepting payments,鈥 said Michael Marchand, spokesman for WHBE, which operates the state鈥檚 health insurance marketplace under the Affordable Care Act (ACA). WHBE officials voted last December to stop managing customer invoices and payments, partly to simplify the process 鈥 eliminating a middleman 鈥 and partly to halt glitches that left hundreds of enrollees with missed payments, lapsed insurance and incorrect bills. (Aleccia, 9/22)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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