Upton Queries CMS On Exchanges

Rep. Fred Upton, R-Mich. sent a letter on Monday to the Centers for Medicare and Medicaid Services seeking more information on regulations regarding insurance exchanges and Medicaid.

Some of the regulations have not been finalized and the Congressman said the uncertainty “has crippled states and health providers in their ability to plan for future Medicaid expansions or state insurance exchanges.”

Upton said states are asking questions about basic requirements including essential health benefits and actuarial value, which have not yet been clarified. 

“The near-silence from HHS on these critical issues is all the more alarming given that the department has required states to submit an exchange application by Nov. 16, 2012, and we are less than 100 days away from this 

deadline,” the lawmaker said in his letter.

Upton said that both the Republican Governors Association and the National Association of Medicaid Directors have queried HHS about specifics of the ruling. The groups requested clarification on 60 issues the states need to know before deciding whether or not to move forward with the Medicaid expansion or exchange. 

He said that CMS may be delaying announcements until after November, but “states do not have the luxury of procrastination.” Upton requested that CMS responds to the questions in the RGA and NAMD letters by September 3. Also that CMS provides them with an outline of all outstanding questions regarding exchanges and Medicaid and when those will be answered. 

Upton chairs the House Committee on Energy and Commerce.