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CMS issues final rule for marketplace navigators

July 12, 2013

The Centers for Medicare & Medicaid Services today issued a final rule outlining the standards for navigators in federally-facilitated and state partnership insurance marketplaces (also known as exchanges). CMS said state-based marketplaces have the option of using this guidance or developing their own. The rule identifies training, conflict of interest standards, and standards for serving people with limited English proficiency or disabilities. Navigators are in-person assisters expected to provide unbiased information to consumers about health insurance, the marketplaces that will facilitate the purchase of qualified health plans in the individual and small group markets beginning in 2014, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program. CMS said that grant awards for navigators in states with federally-facilitated and state partnership marketplaces will be awarded on Aug. 15. AHA staff are reviewing the rule and will have more information for members in a Special Bulletin Monday.