The Health Insurance Enforcement and Consumer Protections Grant Program

The Health Insurance Enforcement and Consumer Protections grants will provide a funding source to assist states in implementing and planning several of the federal market reforms and consumer protections under Part A of Title XXVII of the Public Health Service Act.

The Health Insurance Enforcement
and Consumer Protections grants will provide states with the opportunity to ensure their laws, regulations, and procedures are in line with federal requirements and that states are able to effectively oversee and enforce the PHS Act?s title XXVII Part A provisions with respect to health insurance issuers.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.




Selected Recipients for this Program


RecipientAmount Start DateEnd Date
Illinois, State Of $ 1,377,567   2016-10-312019-10-30
Consumer Affairs And Business Regulation, Massachusetts Office Of $ 1,206,525   2016-10-312019-10-30
Nebraska Department Of Insurance $ 1,068,804   2016-10-312019-10-30
Insurance, California Department Of $ 1,844,585   2016-10-312019-10-30
Insurance, Pennsylvania Department Of $ 1,486,251   2016-10-312019-10-30
Regulatory Agencies, Colorado Department Of $ 1,328,508   2016-10-312019-10-30
Insurance, Indiana Department Of $ 1,297,729   2016-10-312019-10-30
Consumer And Business Services, Oregon Department Of $ 1,245,919   2016-10-312019-10-30
Commerce And Consumer Affairs, Hawaii Department Of $ 1,210,907   2016-10-312019-10-30
Department Of Commerce Minnesota $ 1,160,021   2016-10-312019-10-30



Program Accomplishments

Not Applicable.

Uses and Use Restrictions

Grant funds can be used for a variety of planning and implementation objectives, including but not limited to implementing or enhancing policy form review, market conduct examinations, market analysis, financial examinations, and consumer complaint investigations with respect to the market reforms and consumer protections under Part A of title XXVII of the PHS Act.

The Department of Health and Human Services Grants for Health Insurance Enforcement and Consumer Protections Cycle I funds may not be used for any of the following: cover the costs to provide direct services to individuals, to match any other Federal funds, provide services, equipment, or supports that are the legal responsibility of another party under Federal or State law (e.g.; vocational rehabilitation or education services) or under any civil rights laws, supplant existing State, local, Tribal, or private funding of infrastructure or services such as staff salaries, etc, provide goods or services not allocable to the approved budget, be used by local entities to satisfy state matching requirements, pay for construction, pay for capital.

Eligibility Requirements

Applicant Eligibility

The Health Insurance Enforcement and Consumer Protections grant is open to all states that are currently enforcing the ACA market reforms and also for those states who are not currently enforcing the ACA market reforms to assist with their respective transition to an active enforcement role for all the market reforms and consumer protections under Part A of Title XXVII of the Public Health Service Act.

Beneficiary Eligibility

Grants to States' (including the District of Columbia) for planning and/or implementing the market reforms and consumer protections in Part A of title XXVII of the PHS Act.

Credentials/Documentation

Applicants should review the CMS funding opportunity announcement documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. 2 CFR 200, Subpart E - Cost Principles applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is not applicable.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Application Procedures

2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. Grant applications and required forms for this program can be obtained from Grants.gov. CMS requires all applicants to apply electronically through Grants.gov.

Award Procedures

All qualified applications will be forwarded to an objective review committee. Based on the advice of the objective review committee, the CMS program official with delegated authority is responsible for final selection and funding decisions. Notification is made in writing by a Notice of Grant Award.

Deadlines

Jun 24, 2016 to Jul 25, 2016 A Letter of Intent is mandatory and must be submitted by 5:00 pm Eastern Daylight Time on July 6, 2016. All grant applications must be submitted electronically and be received through http://www.grants.gov by 3:00 pm Eastern Daylight Time on August 15, 2016.

Authorization

Patient Protection and Affordable Care Act (PPACA), Section 1003.

Range of Approval/Disapproval Time

From 30 to 60 days.

Appeals

Not Applicable.

Renewals

Section 1003 of the ACA provides for funding to be awarded between Fiscal Year 2010 and Fiscal Year 2014. Section 2794(c)(2)(B) of the Public Health Service Act specifies that if there are any appropriated Rate Review Grant funds that are not fully obligated by the end of FY14, such amounts shall remain available to the Secretary for grants to states for planning and implementing the insurance market reforms and consumer protections under Part A of title XXVII of the PHS Act. Refer to funding opportunity announcement for additional information on subsequent grants awarded for premium review authorized under Section 1003 of ACA.

Assistance Considerations

Formula and Matching Requirements

Statutory formulas are not applicable to this program. Matching requirements are not applicable to this program. This program has MOE requirements, see funding agency for further details. This program has MOE requirements, see funding agency for further details.

Length and Time Phasing of Assistance

Grant funding for this funding opportunity announcement will be available through FY 2018. See the following for information on how assistance is awarded/released: Grantees drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards. October 31, 2016-October 30, 2018. See the following for information on how assistance is awarded/released: Awards will be created and released by GrantSolutions. See the following for information on how assistance is awarded/released: Awards will be created and released by GrantSolutions.

Post Assistance Requirements

Reports

Quarterly, Annual and Final programmatic reports are required in the funding opportunity announcement.

The FFR Cash Transaction Reports must be filed within 30 days of the end of each quarter.

Failure to submit the report may result in the inability to access grant funds.

Go to www.dpm.psc.gov for additional information.

Submit a quarterly electronic Federal Financial Report (FFR) Cash Transaction Report via the Payment Management System.

The report identifies cash expenditures against the authorized funds for the grant.

Required Quarterly, Annual, and Final Progress Reports.

Grantees must provide HHS with information such as, but not limited to, project status, implementation activities initiated, accomplishments, barriers, and lessons learned in order to ensure that funds are used for authorized purposes.

Such performance includes submission of the state?s progress toward the milestones identified in its Work Plan.

HHS reserves the right to restrict funds for activities related to unmet milestones.

Recipients must submit annual expenditures information through submission of a Federal Financial Report (FFR).

All recipients are required to report on expenditures at least annually.

Since this is a multi-year project, then recipients will be required to report on expenditures every 12 months (on annual Federal Financial Report (FFR or SF-425) and final Federal Financial Report).

Performance monitoring is not applicable.

Audits

In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.

Records

Grantees are required to maintain grant accounting records 3 years after the date they submit the final Federal Financial Report. If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.

Financial Information

Account Identification

75-0112-0-1-551.

Obigations

(Project Grants) FY 16 $0; FY 17 est $25,547,052; and FY 18 est $0

Range and Average of Financial Assistance

Grantees will receive a minimum of $476,998 as a baseline award amount.

Regulations, Guidelines, and Literature

This program is subject to 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards implemented by HHS regulation 45 CFR Part 75, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards.

Information Contacts

Regional or Local Office

None.

Headquarters Office

Jim Taing 200 Independence Avenue, Washington, District of Columbia 20201 Email: james.taing@cms.hhs.gov Phone: 301-492-4182

Criteria for Selecting Proposals

Approval of an application will be based on an analysis of the factors set forth in Section V--Application Review in the funding opportunity announcement.



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Edited by: Michael Saunders

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