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Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges

$536,382,414

Total Assistance, FY 2008 to Present
Agency: CENTERS FOR MEDICARE AND MEDICAID SERVICES, HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Assistance Type: COOPERATIVE AGREEMENTS
Popular Name: Navigator Grants
Assistance Listing Number
93.332

Objectives: The Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges (Funding Opportunity) will enable recipients to operate as Exchange Navigators in states with a Federally-facilitated Exchange (FFE), as authorized by the Affordable Care Act (ACA). Section 1311(i) of the ACA requires Exchanges to establish a Navigator grant program. The Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Final Rule (2022 Payment Notice (PN)) amended 45 C.F.R. § 155.210(e)(9) to reinstitute the requirement that Navigators in the FFEs provide information and assistance with regard to certain post-enrollment topics, such as the Exchange eligibility appeals process, the Exchange-related components of the Premium Tax Credit (PTC) reconciliation process, and the basic concepts and rights of health coverage and how to use it. The HHS Notice of Benefit and Payment Parameters for 2024 final rule at https://www.federalregister.gov/d/2023-08368/p-142, effective 6/18/2023, removed the prohibition, i.e., now allowed, for Navigators, non-Navigator assistance personnel, certified application counselors (CACs), and CAC Designated Organizations (CDOs) in FFEs from going door-to-door or using unsolicited means of direct contact to provide application or enrollment assistance.

 
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