Author Archives: Cynthia Marcotte Stamer

About Cynthia Marcotte Stamer

Management attorney and operations consultant Cynthia Marcotte Stamer uses a client objective oriented approach to help businesses, governments, associations and their leaders manage people, performance, risk, legislative and regulatory affairs, data, and other essential elements of their operations.

Agents, Brokers Register For CMS Hosts 2018 PY ACA Exchange Agent & Broker Training On 7/20, 21, 26, & 27

Agents and brokers planning to market health insurance coverage sold through the health care marketplaces established under the Patient Protection and Affordable Care Act (ACA) should register and participate in one of the upcoming “Plan Year 2018 Registration & Training … Continue reading

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CMS Updates For Health Insurance Issuers On ACA Enrollment & Payment Data Reporting

Associations, Consumer Operated and Oriented Plan (CO-OP) Programs, Stand Alone Dental Plans, Federally-faciliated Marketplace (FFM) Issuers, State Based Marketplaces, SBM Issuers, and Small Business Health Options Program (SHOP) issuers should review the Centers for Medicare & Medicaid Services (CMS) Payment…

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Tri-Agencies Update On Planned ACATransparency Reporting Rules For Non-QHP Issuers & Non-Grandfathered Group Health Plans

The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) today (August 11, 2015) jointly released updated information about how the Departments plan to develop rules to implement the data reporting rules needed to…

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Health Plans, Sponsoring Employers & Others Urged To Act Immediately In Response To Premera, Anthem Blue Cross Breaches

Today’s report by Premera Blue Cross of a massive data breach affecting as many as 11 million customers’ personal health and financial information on the heels of the large-scale data breach announcement by fellow Blue Cross Association, Anthem, is another reminder…

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State Exchange Problems Added ACA Threat Regardless of SCOTUS Decision In King v. Burwell

While most Americans are familiar with the well-publicized issues and higher than projected premium costs of coverage offered to Americans enrolling in health care coverage through the federal healthcare marketplace Healthcare.gov created under the health care reforms of the Patient Protection…

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Agencies Clarify Applicability of ACA Out-Of-Pocket Versus Deductible Cost Sharing Limitations

Non-grandfathered self-insured and large group health plans must comply with the out-of-pocket limits in 2014 but pending further guidance are excused from the duty to comply with deductible limitations imposed by the cost-sharing limitations of the Patient Protection & Affordable…

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New OCR Guidance Assigns More HIPAA Homework Health Plans, Providers, Business Associates and Employers

Think your?health plan, health care organization, health care clearinghouse or their business associates?has health care privacy covered?? Think again. A series of supplemental guidance issued by the Department of Health & Human Services Office of Civil Rights (OCR) in recent…

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HHS Extends Proposed EDI Rule Time to 4/3 To Get More Input From Self-Insured Plans, TPAs

Third party administrators? (TPAs), self-insured health plans and concerned payers and plan sponsors now have a little more time to comment on the Department of Health & Human Services (HHS) proposed rule, “Administrative Simplification: Health Plan Certification of Compliance.” HHS…

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Use Care Before Using “Skinny Plan” Option

Employers considering skinny plans and the brokers, third party administrators (TPAs), insurers and consultants recommending the use of these arrangements alone or as part of a broader health plan design should seek qualified legal advice for help with structuring and…

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OCR Warns Others Learn From WellPoint’s $1.7 M HIPAA Settlement

WellPoint $1.7 M HIPAA Settlement Expensive Lesson On HIPAA Risks Of Leaving PHI Too Accessible In Web-Based Applications As health plans and health care organizations increasingly jump on the Web-based application bandwagon, managed care company WellPoint Inc. (WellPoint) is learning a $1.7…

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