Modern Healthcare by Jaimy Lee –
August 8, 2013:
HHS is preparing to award $54 million in grants to navigators—organizations that will provide impartial information to the public about signing up for coverage on the state health insurance exchanges. Navigators are not allowed to recommend particular health plans. These grants will go to navigator organizations in states where the federal government will operate the exchanges. The states operating their own exchanges are choosing navigator groups on their own.
Navigators and other helpers called in-person assisters are expected to be critical in explaining to consumers—many of whom have never bought health insurance directly—how to apply for private or Medicaid coverage on the exchanges, how to qualify for federal subsidies and how to select a plan. In many states, insurance brokers also will receive training and be able to sell exchange coverage to consumers.
But there are widespread concerns about whether there is enough time before the Oct. 1 launch of the exchanges for adequate training of navigators. There also are concerns about the potential for conflict of interest and fraud.
Navigators could include community not-for-profit groups, chambers of commerce, tribal organizations and labor unions.
Navigators will receive up to 30 hours of training, according to a final rule released last month by the CMS, which does not set out a minimum training requirement. Some states are requiring that navigators receive additional training.
According to an HHS spokeswoman, navigators must complete about 20 hours of initial base training, which will be conducted online during the six weeks between Aug. 15 and the Oct. 1 start of the open enrollment season. They are then expected to take on “refresher” training through the six-month open enrollment period.
“Our grantees will be organizations who have established records of serving their communities and have pre-existing networks,” HHS’ spokeswoman said in an e-mail. “We view training as an ongoing process, and will continue to offer refresher training courses throughout the six-month open enrollment period as we respond to consumers’ needs.”
HHS has not yet released the training package that will outline training requirements for navigators. The training is required to include information about qualified health plans, insurance affordability programs, eligibility and enrollment rules and procedures, and privacy and security standards.
HHS said a report in the Wall Street Journal that it was reducing navigator training requirements because of tight timelines before the Oct. 1 launch of the exchanges was not accurate.