Response to public comments

CMS Response to Public Comments Received for CMS-10494

The Centers for Medicare and Medicaid Services (CMS) received comments from certified
application counselor organizations, consumer advocacy organizations, trade groups, and states
CMS-10494. This is the reconciliation of the comments.
Comment:
The Centers for Medicare and Medicaid Services (CMS) received mixed comments related to
our proposal to collect data from certified application counselor organizations. Many
commenters supported the proposal, noting the value of tracking performance data. Many
commenters also requested that we coordinate with the Health Resources and Services
Administration (HRSA) on their ACA Health Center Outreach and Enrollment Assistance grant
reporting requirements that affect Federally Qualified Health Centers that are also serving as
certified application counselor organizations in order to reduce duplication and administrative
burden.
Response:
CMS agrees that the data will enhance the Exchanges’ ability to oversee and support
certified application counselor organizations, target outreach and education efforts, and
identify training needs. In FFEs, CMS believes the information and data we proposed to be
collected aligns well with HRSA’s ACA Health Center Outreach and Enrollment
Assistance grant reporting metrics.
Comment:
CMS also received several specific suggestions for data elements to be collected by Exchanges,
including metrics related to re-enrollment, assistance to non-English speakers, and postenrollment activities. One commenter requested that CMS develop a means for certified
application counselor organizations to voluntarily report additional information that falls outside
of the proposed performance measures.
Response:
To minimize the burden on certified application counselor organizations, CMS is not
adding to or changing the kind of information and data to be collected. Because certified
application counselors are not required to perform post-enrollment activities, CMS will not
require them to report on any post-enrollment assistance they provide.

Comment:
A few commenters opposed this proposal, arguing that the requirements would be overly
burdensome and could lead some certified application counselor organizations to discontinue
their programs. Many commenters urged CMS to minimize the burden associated with certified

application counselor performance data reporting. Several commenters expressed concern
regarding the scope and frequency of the proposed reporting requirements, and recommended
requiring less frequent reporting.

Response:
CMS intends that any FFE information collection be straightforward, and place little
burden on certified application counselor organizations, particularly given the resource
constraints faced by many certified application counselors. CMS recognizes that certified
application counselor programs are not required to be funded by Exchanges. In FFEs, to
help minimize any burden on certified application counselors and certified application
counselor organizations, while still providing FFEs enough information to meaningfully
improve oversight of certified application counselor programs, CMS finalized a quarterly,
rather than monthly, reporting schedule. CMS believes that quarterly reports will provide
FFEs with sufficient information to meaningfully improve oversight of certified application
counselor programs.
Comment:
A few commenters agreed that SBEs should have the option to establish their own reporting
requirements to align with their needs. A few commenters requested that SBEs be allowed an
exemption from this proposal if they determine that the administrative costs are too burdensome.
One commenter requested that HHS establish limits on both the scope and frequency of
performance data reporting requirements in all Exchanges. Commenters also noted that certified
application counselor organizations that operate under the umbrella of national organizations
would benefit from standardized reporting requirements across all Exchanges.
Response:
In SBEs and SBE-FPs, this provision only requires that organizations submit information
and data to the SBE upon request, in the form and manner specified by the SBE, and
therefore affords SBEs and SBE-FPs the flexibility to establish standards appropriate to
their own specific needs and objectives. SBEs and SBE-FPs may weigh any increased
administrative costs of requiring regular reports against the benefits of having additional
information about the consumer assistance landscape in their State and decide whether,
how, and when to collect data from certified application counselor organizations. In
addition, CMS encourages SBEs and SBE-FPs to take into consideration the impact their
reporting requirements will have on organizations that also serve as certified application
counselor organizations in States with an FFE. CMS encourages SBEs and SBE-FPs to
consider using, at a minimum, the data elements used by the FFE, in order to minimize the
burden on organizations that also serve as certified application counselor organizations in
States with an FFE, but they are not required to do so if they do not believe that doing so
fits their State’s circumstances.