On April 19, the U.S. Department of Health and Human Services (HHS) established the Office of Consumer Information and Insurance Oversight, which will be the HHS arm charged with implementing many of the insurance provisions in the Patient Protection and Affordable Care Act (PPACA). The responsibilities of the office include:
- Ensuring that carriers are compliant with new insurance market rules (e.g., rescissions, pre-existing condition exclusions for children);
- Overseeing new medical loss ratio rules and assisting states in reviewing insurance rates;
- Providing guidance and oversight for state-based insurance exchanges; and
- Administering the temporary high-risk pool program and early retiree reinsurance program.
The Office of Consumer Information and Insurance Oversight has several subdivisions:
The Office of Oversight
This office will implement, monitor compliance with, and enforce the new rules governing the insurance market and the new rules regarding medical loss ratios. It will also be responsible for rate review at the federal level, and for providing rate review grants to states.
The Office of Insurance Programs
This office will administer the temporary high-risk pool program and associated funding to states, as well as the early retiree reinsurance program.
The Office of Health Insurance Exchanges
This office will establish policies and rules governing exchanges, establish and implement planning grants to states, and provide oversight for the exchanges.
The Office of Consumer Support
This office will compile and maintain data for an Internet portal providing information on insurance options, provide assistance to enable consumers to obtain maximum benefit from the new health insurance system, and administer the consumer assistance grant program for states.
The Director’s Office
This office will provide leadership and support to the entire organization and will have components for planning, evaluation, regulatory affairs, external affairs, and administrative management.
In compliance with PPACA, the office will launch a consumer website with information to help individuals and small businesses consider insurance options in their states by July 1. Consumers will be able to access information about private insurance, high-risk pools, Medicaid, and CHIP. Insurance carriers were required to submit information regarding the products they sell per state by May 21.
An organizational chart for the new HHS office is available here.
