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Policy Synopses at the Federal and State Level
Stacey Kram, Salisbury University
Federally Facilitated Changes• Created by the Robert Wood
Johnson Foundation
• Discusses the implications of state versus federally run insurance exchanges
What is an Exchange?
• One stop shopping
• State-run
• Regionally –run
• Federally facilitated
The Core Functions of an Exchange
• Setting eligibility requirements
• Enrollment assistance
• Plan management specifications
• Consumer assistance
• Financial management
Foreseen Complications with Federally Facilitated Exchanges
• States will have locally and federally regulated plans simultaneously
• Meeting local regulations of various states
• “Churning”
More Complications…
• “Adverse selection threats”
• Limits on Medicaid expansion
• Customer service
A More Practical Approach?
• Creation of state-based exchanges
• Expansion of Medicaid
• Extending deadlines to states
• Offering establishment grants
Telehealth Provider Credentialing
• MD House Bill 1042, introduced February 8, 2013
• Discusses overcoming barriers to telehealth delivery
Current Complications
• CMS requirements for reimbursement
• Legislation slow to change at state level
• Excessive cost and burden to rural organizations and telemedicine providers
More Complications…
• Limited access to specialty care
• Single-site provider is cost-prohibitive
• Current estimate of $4.8 million annually for one provider
A More Practical Approach?
• Credentialing by Proxy
• Federal Credentialing Program for Health Care Providers– VetPro
References
• Health Affairs. (2013, January). Federally facilitated exchanges. Retrieved from: http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_84.pdf
• Hospitals-Credentialing and Privileging Process-Telemedicine, MD- H.B. 1042, 2013 Regular Season. (2013).
• National Rural Health Association. (2010).
Telehealth provider credentialing. Retrieved from: http://www.nrharural.org
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