1. Stacey Kram, Salisbury University
Policy Synopses at the
Federal and State Level

2. Federally Facilitated Changes
• Created by the Robert Wood
Johnson Foundation
• Discusses the implications of state
versus federally run insurance
exchanges

3. What is an Exchange?
• One stop shopping
• State-run
• Regionally –run
• Federally facilitated

4. The Core Functions of an
Exchange
• Setting eligibility requirements
• Enrollment assistance
• Plan management specifications
• Consumer assistance
• Financial management

5. Foreseen Complications with
Federally Facilitated Exchanges
• States will have locally and federally
regulated plans simultaneously
• Meeting local regulations of various
states
• “Churning”

6. More Complications…
• “Adverse selection threats”
• Limits on Medicaid expansion
• Customer service

7. A More Practical Approach?
• Creation of state-based exchanges
• Expansion of Medicaid
• Extending deadlines to states
• Offering establishment grants

8. Telehealth Provider Credentialing
• MD House Bill 1042, introduced
February 8, 2013
• Discusses overcoming barriers to
telehealth delivery

9. Current Complications
• CMS requirements for
reimbursement
• Legislation slow to change at state
level
• Excessive cost and burden to rural
organizations and telemedicine
providers

10. More Complications…
• Limited access to specialty care
• Single-site provider is cost-prohibitive
• Current estimate of $4.8 million
annually for one provider

11. A More Practical Approach?
• Credentialing by Proxy
• Federal Credentialing Program for
Health Care Providers
– VetPro

12. References
• Health Affairs. (2013, January). Federally
facilitated exchanges. Retrieved from:
http://healthaffairs.org/healthpolicybriefs/brief_pdf
s/healthpolicybrief_84.pdf
• Hospitals-Credentialing and Privileging
Process-Telemedicine, MD- H.B. 1042, 2013
Regular Season. (2013).
• National Rural Health Association. (2010).
Telehealth provider credentialing. Retrieved
from: http://www.nrharural.org