Software problems complicate health exchange prep


Health insurers already face an uphill battle to prepare for federal and state-run health insurance exchanges by next year, and they have likely encountered a new challenge coming from delays in a key computer program required to participate in exchanges.

State consultants and insurance regulators are warning than an electronic system, which insurers will use to submit proposed plans and obtain approval of those plans, won't be ready for testing next month because federal officials haven't issued certain rules needed to update the software, reported Kaiser Health News.

Interrupting the software testing schedule could potentially create a three-month delay in getting exchanges up and running. That means insurers could face increased pressure as they try to prepare for the Oct. 1 opening of the exchanges.

As it is, "speed and timing is of the essence" and insurers should "start working on it yesterday," David Merrit, managing director of Leavitt Partners, told FierceHealthPayer in an interview this month.

Insurers already use the electronic system, known as the System for Electronic Rate and Form Filing (SERFF), in almost every state to electronically file applications for new products and premium adjustments. But the SERFF software must be updated for the exchanges so state and federal regulators can determine whether insurers' proposed policies meet an exchange's standards.

"The timeline is definitely getting crunched," Joel Ario, former head of exchange planning for the U.S. Department of Health & Human Services and current consultant with Manatt Health Solutions, told KHN. "Insurers tell me they will need final approval of their products by July 1 so they will have three months to actually get set up to market them."

Some regulators think such a logjam is reason enough to postpone the exchanges' debuts. "If I could wave a magic wand and change (the start) from 2014 to 2015, I would," Sandy Praeger, Kansas' elected insurance commissioner, told KHN. "But I don't know if [federal lawmakers] can do that."

To learn more:
- read the Kaiser Health News article

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