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-.,,........,
Adtm'uistrator
Washing!<"' OC 2020 I
JAN 28 2016'
The following are action steps that Kentucky will need to take immediately assuming the state
intends to transition for the 20 I 7 plan year. CMS' s team is ready to provide you with whatever
assistance you need in order to expeditiously take the following steps.
I. Identify a point of contact in the state who will have ultimate responsibility for the
transition activities and will coordinate, as appropriate, with Kynect. In addition, we will
require Kentucky to establish a centralized project coordination team (or Project
Management Office) that will be responsible for coordinating activities among the
different agencies and with Kynect, and for tracking completion of all required transition
milestones.
2. Provide a detailed plan for how Kentucky wi.ll continue to meet its obligations as an SBM
through the 2016 plan year, including having the eligibility and enrollment functionality
to process changes in circumstances or special enrollment pedods for 2016 current and
new enrollees.
3. Facilitate discussions between CMS and the issuers participating in Kynect. These
discussions will ensure that issuers understand the transition activities underway, the
FFM's onboarding requirements, FFM deadlines, plan management and QHP
certification requirements, and the 3.5 percent fee that issuers participating in the FFM
must pay. The window for submission of QHP applications is proposed for April I I ,
2016, and all other operational deadlines are available in the Draft 2017 Letter to Issuers
in the Federally-facilitated Marketplaces.
4. Begin the process required to enter into necessary contracts with a vendor to modify the
Kynect system to decouple the Marketplace from Medicaid/CHIP and build new system
functionality that enables bi-directional exchange of applications between the FFM and
Kentucky's Medicaid/CHIP systems and to implement other system requirements unique
to FFM states. CMS will work with the state on these requirements, and will provide
further clarity on the availability of any Medicaid funds for the costs associated with
building the new functionality.
5. Provide a detailed plan for how Kentucky will meet its ongoing statutory and regulatory
requirements for 2014, 2015, and 2016 Marketplace consumers, which include:
Facilitating the ability of2016 Kynect consumers to reapply to the FFM for 201 7
coverage through data sharing with the FFM and focused outreach and consumer
assistance;
Submitting outstanding monthly and annual reporting to the Internal Revenue Service
(IRS);
Sending IRS 1095-A forms to 2016 consumers starting in January 2017 and
maintaining capabilities to provide ongoing and long-term support for all consumers
who require assistance or have corrections to their I095-A forms.
Submitting all requested CMS policy-level enrollment reporting.
Maintaining capabilities to process eligibility appeals for consumers.
As noted, my team is available to discuss these items, in addition to the next steps to develop a
transition workplan and timeline.
Please feel free to reach out to me or my staff with questions.
Sincerely,
Andrew M. Slavitt
Acting Admiinistrator