Affordable Care Act Implementation Tools

Affordable Care Act Implementation Tools

Support for this tool kit was provided by a grant from the Robert Wood Johnson Foundation’s State Health Reform Assistance Network program, and was developed to help States with strategic planning and resource allocation based on ACA provisions, regulations, and other guidance.

Sample Work Plans and “cheat sheets” summarizing specific selected federal standards (available on request)

ACA implementation work plan for insurance regulators (template) – a matrix organized by activity designed to ensure that “nothing falls through the cracks.” This strategic planning tool is designed to assist insurance regulators with resource planning and programmatic issues. Includes certain plan management functions.

Topic-specific work plans and “cheat sheets”

  • EHB work plan
  • Plan Management Tasks
  • External Review/Internal Appeals
  • QHP Ceritification

Insurance code Self Audit Tool – a guide for state insurance regulators for analysis of state insurance codes, regulations, bulletins and other regulatory guidance to ensure consistency with the Affordable Care Act.

Exchange Functions checklist – For a state to be certified by HHS as having a state-based exchange, all functions must be directly performed by an Exchange of the Exchange of must have agreements with others to perform those. More than a list of required functions, the Exchange Functions document is a tool that a State agency (and quasi-state agency) can use to identify and document functions it currently performs those and to determine if, when Exchanges are set up, the State agency should continue to perform those and similar functions or have another state agency assume those functions. This tool can also be used to help determine where there is overlap among agencies and to ensure that none of the essential functions that an Exchange must perform fall through the cracks.

Once completed, the Exchange Functions checklist can be used as a basis for agreements/ Memoranda of Understanding as required by the federal government in the Exchange Establishment rules.