CMS to challenge state navigator restrictions

Now that several states have passed laws either limiting the reach of navigators or burdening them with additional requirements, the Centers for Medicare & Medicaid Services said it's ready to push back against these restrictions, The Washington Post reported.

In a rule published last week, CMS mentioned plans to address state navigator laws, noting that it will specify which state laws prevent navigators from performing their responsibilities. "We further intend to propose that, in specific circumstances, certified application counselor designated organizations may serve targeted populations without violating the broad nondiscrimination requirement related to exchange functions," the rule states.

Although CMS officials declined to discuss the new policy before it's been formalized, they defended the navigator program. "Navigator grants are given to trusted community organizations that have a track record of working in their communities," the agency said in a statement, the Post noted.

Seventeen states have passed laws that go beyond requirements allowed under the Affordable Care Act. Some of the most restrictive laws, passed in Florida, Georgia, Indiana, Maine, Missouri, Montana, Tennessee, Texas and Wisconsin, require navigators to undergo extra training and testing requirements and pay fees before they can obtain a state license, FierceHealthPayer previously reported.

Some industry experts fear these laws affect enrollment in the health insurance exchanges because they effectively prevent navigators from educating consumers about how to access the online marketplaces.

"To the extent that [CMS] says that it is going to go ahead with instructing states that there are certain things they can't do, it's a good place for [CMS] to start," Jay Angoff, a former Obama administration health official who is leading a legal fight against state navigator restrictions, told the Post.

To learn more:
- here's the CMS rule
- read The Washington Post article

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