NM HIX Update for Tribes

NM Health Insurance Exchange (HIX) Update.

The first meeting of the NM Health Insurance Exchange Board will be held on April 29 and 30, at the NM Workforce Training Center, Meeting Room 207, 5600 Eagle Rock Ave. NE Albuquerque, NM 87113.

The following is the best contact information I could find for the newly appointed New Mexico Exchange Board.

David Shaw – CEO, Nor-Lea Hospital District – david.shaw@nlgh.org
Dr. Martin Hickey – CEO – New Mexico Health Connections - Fax: (505)-633-8021 (fax)
Jason Sandel – New Mexico Insurance Pool - jsandel@fmtn.org
Larry Leaming – COO Roosevelt General Hospital - lleaming@myrgh.org
Patsy Romero – COO Easter Seals El Mirador – p.romero@eselm.org
Terianne Everhart – Las Cruces businesswoman - terriane@msn.com
J.R. Damron – Santa Fe Physician – I couldn’t get his email contact info.
Gabriel Parra – Lawyer for Presbyterian Healthcare Services, NM – gparra@phs.org
Ben Slocum – Lovelace Health Plan CEO – ben.slocum@lovelace.com
Dr. J. Deane Waldman – UNM Health Sciences Professor - (505)272-1212 (fax)
Sidonie Squier – Human Services Secretary - betina.mccracken@state.nm.us

Teresa Gomez- gomezt@futuresforchildren.org.

The board will be discussing applying for additional federal funding for the Exchange, including funding for in-person assistance programs, deadline for this funding is May 15th. As Tribes I think that it is important to have some tribal leaders or representatives present at the meeting during the CIICO call in portion to bring up the Native American Service Center funding/development and the complete lack of Direct Tribal Consultation during the development of the all Exchange regulations and policies.  

There was some discussion regarding available funding for navigators from the Federal Government, at a couple of webinars hosted by CIICO.  Currently Tribes are not eligible for Navigator funding, because of the type of Exchange the State is proposing, a State based Exchange where all portions of the Exchange are administered by the State of NM (eligibility, enrollment, outreach, education, IT). 

Tribes would be eligible for additional Funding from the Federal Government CIICO determines that NM will not be able to create an Exchange by certain deadlines.  In the event that the State is not able to create a state-based exchange it will be recommended that NM create a state Federal partnership, in which the State will be responsible for some administration functions and the Federal Government would be responsible for the rest.  Under this structure the State would be responsible for outreach education and Navigators, and the Federal Government would be responsible for eligibility Health plan selection and the IT web portal.

The other option would be to go with the Federal Exchange that is going to be developed to serve State populations where the State’s Governor has declined the option of developing an Exchange.  In this option the Federal Government administers all parts of the Exchange and there will be no funding for States for Navigators or in-person Assisters.

There was also a letter sent to CIICO by members of the Native American Workgroup (NAWG) of the Health Insurance Exchange Task Force regarding the $1.28 Million set aside for the Native American Service Center (NASC) in the Level I Establishment Grant procured in 2011 by the Office of Health Care Reform (OHCR).  The NASC was intended to be a resource for Native Americans hoping to enroll in the HIX.  As of today there has been no response to that letter/request from CIICO.  I have been in contact Senator Heinrich’s and Representative Lujan-Grisham office’s in an attempt to get a response to this request.

 Below is the Agenda for the HIX Board Meeting:

New Mexico Health Insurance Exchange Inaugural Board Meeting

April 29, 2013  
 (Morning Session)

1. Introductions of Board  – Superintendent Franchini

2. Review of NM legislation 
3. Board of Director NMHIX Introductions and appointment fact sheet
4. Election of Chair & Vice Chair & Treasurer
5. Board Policies 
         a. Conflict of interest
         b. Attendance, by telephone or by alternate media
6. Resolutions giving Executive Director authority regarding documents and funds (checking accounts, procurement policies, signing authority)
7. Development of meeting schedule
8. Funding
         a. Available grant funds / Process for transfer of funds to NMHIX
        b. Leveraging NMHIA staff, processes and federal fund business assessment
         c. 5/15/2013 Grant application
         d. Existing HIA MOU
         e. New MOU with DOI 9. 12:00 pm MT/ 2:00 pm ET - CCIIO available for questions from board. 

(We will stop at 12:00 for this, break for lunch and then resume agenda items.)  
Lunch Break (Lunch will be provided to board members) 

(Afternoon Session)

10. Review of first year exchange options and decision timeline

11. Review of Plan Management, NM DOI
12. Review of HSD Task Force NMHIX recommendations 
13. Consumer outreach and assistance
14. Native American Service Center (NASC)  

Day 2

NMHIX Inaugural Board Meeting Agenda     April 30, 2013

15. Committees a. Standing Board -Finance/ Operations & Benefits /Marketing / Information Technology / NMHIA b. Advisory -Native Americans - On & Off Reservation, Qualified Employer representatives, Low income and underserved (consumer) advocates, Transition Committee (Active members from NMHIA and NMMIP),  Health Insurers, Health Care Providers, Brokers and Agents, and Medicaid and State Agencies

16. Discussion/ development of initial NMHIX budget/ Staffing 
17. NMHIA Organization Chart and prior board actions
18. NMHIA implementation efforts
19. NMHIA wind down review
20. NMHIA assessment (must be approved by May 30) 
Public Comment & Adjournment 
21. Public Forum
22. Adjournment    

Parking lot for future meeting topics: 

Draft Plan of Operations NMHIA audit
Medicaid integration with HIX  
Board Reference Book
 NMHIX SB221
 Draft Plan of operations
 NMHIX Blueprint/ CCIIO Schedule of Activities
 PM and IT RFP/ Amendment #5 
 NMHIA Conflict of interest Policy
 NMHIA Consultant procurement Policy
  November 2012 NMHIA Board Retreat Discussion Guide
 NMHIA Proposed Organization chart
 NMHIA Proposed Job Descriptions 
 Mileage and Per diem reimbursement Forms
 Calendar
 Teleconferencing Dial in information