8/15/13 Treasury/ IRS published final and temporary regulations called "Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return."

The temporary regulations provide guidance to charitable hospital organizations on the community health needs assessment (CHNA) requirements and related excise tax and reporting obligations. Under ACA §9007, charitable hospital organizations are required to conduct CHNAs and adopt implementation strategies at least once every three years. The temporary regulations clarify that charitable hospital organizations that fail to meet the requirements must pay an excise tax and file Form 4720 along with the return. The regulations also state that organizations must file this form by the 15th day of the fifth month of an organization's taxable year during which the liability was incurred. The temporary regulations are effective August 15, 2013.

8/15/13 The Treasury/IRS also published a notice of proposed rulemaking on "Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return." The notice of proposed rulemaking provides an opportunity for public comment on the temporary regulations.

Comments and requests for a public hearing are due on November 13, 2013.

For more information on the ACA and Charitable 501(c)(3) Hospitals visit: IRS.Gov

News

Under the ACA, enrollment assistance can be provided by: Navigators, in-person assistance personnel, or certified application counselors. In addition, agents and brokers can also help consumers enroll in new insurance options. On July 17, 2013 HHS published a final rule which details standards for Navigators and non-Navigator assistance personnel in Federally-facilitated and State Partnership Exchanges. It also sets standards for Non-Navigator assistance personnel in a State Exchange who are funded through federal Exchange Establishment grants and certified application counselors in the Exchange. All enrollment assisters are required to complete a specific training and are subject to federal criminal penalties for violations of privacy or fraud statutes.

The ACA established Affordable Insurance Exchanges (§1311(b)) to provide individuals and small business employees with access to health insurance coverage beginning January 1, 2014. §1311(d) and §1311(i) also direct all Exchanges to award grants to Navigators that will provide unbiased information to consumers about health insurance, the Exchange, QHPs, and insurance affordability programs including premium tax credits, Medicaid and the Children's Health Insurance Program (CHIP). The Navigator program will provide outreach and education efforts and assistance applying for health insurance coverage. If states choose not to run either a State-Based Exchange or a State-Federal Partnership Exchange, HHS will operate a Federally-facilitated Exchange (§1321).

Learn more about Navigators and types of enrollment assistors at: http://cciio.cms.gov/programs/exchanges/assistance.html

View a list of HHS Navigator grant recipients at: CMS.Gov

Commonwealth of MA News

7/22/13 The Massachusetts Health Connector announced that 10 organizations across the Commonwealth will receive grants in the first year of the Massachusetts Navigator program. The Massachusetts Navigator program will help consumers understand new coverage options available as a result of the ACA and find the most affordable coverage that meets their needs. Navigators will assist individuals, families and small businesses from application through enrollment into new health insurance plans using culturally-and linguistically-appropriate methods. Through community outreach events, on-site enrollment assistance, with multi-lingual tools and ethnic media, the 10 selected organizations will assist Massachusetts residents in getting health insurance coverage through the Health Connector.Navigators are required to adhere to strict security and privacy standards and complete a specified course of training.

The Health Connector completed its Navigator selection process in July, which relied upon a competitive review process. All applications were first screened for compliance with core ACA requirements for Navigators, including eligibility to serve as a Navigator and review of any potential conflicts of interest. Those applicants that moved to the next round were evaluated on the following:

- Experience and ability to meet requirements

- Overall programmatic response

- Positive references and demonstrated experience with transitioning populations

- Overall value to the Commonwealth during this transition period

- A detailed budget demonstrating the unique value grant funds would provide to bolster any ongoing outreach or enrollment efforts of the organization

Based on this process, the Health Connector selected the following 10 highest-scoring applicants:

1.       Boston Public Health Commission

2.       Caring Health Center

3.       Community Action Committee of Cape Cod & Islands, Inc.

4.       Ecu-Health Care

5.       Greater Lawrence Community Action Council

6.       Hilltown Community Health Care Centers

7.       Joint Committee for Children's Health Care in Everett

8.       Manet Community Health Center

9.       MAPS - Mass Alliance of Portuguese Speakers

10.     PACE - People Acting in Community Endeavors

Learn more about the Massachusetts Health Connector Navigator Grant Program and view a list of the Grant Program Awardees at: MA Health Connector

MassHealth Section 1115 Demonstration Extension

EOHHS plans to submit a request to extend the MassHealth Section 1115 Demonstration to the Centers for Medicare and Medicaid Services (CMS) on September 30, 2013. The MassHealth Section 1115 Demonstration provides federal authority for Massachusetts to expand eligibility to individuals who are not otherwise Medicaid or CHIP eligible, offer services that are not typically covered by Medicaid, and use innovative service delivery systems that improve care, increase efficiency, and reduce costs.

The Demonstration Extension Request outlines the specific authorities being requested from CMS from July 1, 2014 to June 30, 2019 to sustain and improve upon the gains in coverage, affordability and access to health care achieved to date under the Demonstration. Consistent with Chapter 224 and the Affordable Care Act, the next phase of the Demonstration focuses on cost containment and delivery system reforms. This request will affect eligibility, benefits, payment methodologies and delivery systems, as well as changes to expenditure authorities under the Demonstration.

Written comments must be received by EOHHS by 5 pm, September 19, 2013.

Comments may be sent to: laxmi.tierney@state.ma.us, or mailed to:

EOHHS, Office of Medicaid

Attn: Laxmi Tierney

One Ashburton Place, 11th Floor

Boston, MA 02108