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Proposed CMS Rule Says Navigators Don’t Need E&O

The Centers for Medicare & Medicaid Services of the Department of Health and Human Services released proposed rules on March 14 covering many topics related to the Affordable Care Act, requesting comment...
March 20, 2014

The Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services (HHS) released proposed rules on March 14 covering many topics related to the Affordable Care Act (ACA), requesting comment.

In the section of the rules discussing navigators, the Obama administration’s document says “A state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law requires that at least one such group be listed as a navigator. The proposed rule is largely a directive to states, so they do not begin any sort of E&O requirement.

Friday’s regulations also included a formal directive to the states preventing them from passing any laws requiring a navigator to refer a consumer to an agent or broker for any reason. The language says, “Non-federal laws or regulations that require referrals to sources that are not required to provide impartial advice would, on their face, make it impossible for these assisters to comply with existing federal statutory and regulatory duties and standards.”

PIA National will file comments in disagreement with certain of these proposed regulations during the 30-day comment period.

HHS Proposed Rules (Federal Register 3/14/14)

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