Sec. 1262.
(1) Beginning June 30, 2015, an individual shall not act as a navigator unless he or she has filed an application under section 1263(1) and is certified with this state as a navigator.
(2) Unless certified as a navigator, an individual shall not receive funding from an exchange.
(3) Subject to the affordable care act, a certified navigator shall do all of the following:
(a) Conduct public education activities to raise awareness of the availability of qualified health plans.
(b) Distribute fair and impartial information concerning enrollment in all qualified health plans offered within the exchange and the availability of the premium tax credits under section 36B of the internal revenue code of 1986, 26 USC 36B, and cost-sharing reduction under section 1402 of the affordable care act.
(c) Facilitate selection of a qualified health plan.
(d) Provide referrals to appropriate state agencies for an enrollee with a grievance, complaint, or question regarding the enrollee's health plan, coverage, or a determination under such plan coverage.
(e) Provide information in a manner that is culturally and linguistically appropriate to the needs of the population served by the exchange.
(4) A certified navigator shall not do any of the following:
(a) Sell, solicit, or negotiate health insurance.
(b) Recommend a particular health benefit plan.
(c) Provide any information or services related to insurance regulated under this act other than health benefit plans or other products offered in the exchange.
(5) If an exchange is operational in this state, the director shall determine whether a program to certify and train navigators protects the privacy and security of personally identifiable information of the residents of this state under the laws of this state. If the director determines that the program does not protect the residents of this state under this subsection, the director shall do all of the following:
(a) Establish a certification and training program that must include, but is not limited to, all of the following:
(i) A criminal history check using the department of state police's internet criminal history access tool (ICHAT).
(ii) Training on privacy and security of personal identifying information, training on ethics, training on provisions of the affordable care act relating to navigators and certified application counselors and any necessary state-specific training as determined by the director.
(b) Develop an application and disclosure form by which an applicant for a certificate shall disclose any potential conflicts of interest, as well as any other information required by the director.
(c) Submit an annual report to the standing committees of the senate and house of representatives with jurisdiction over health policy. The report must include all of the following:
(i) The director's assessment of any federal program to certify and train navigators and certified application counselors.
(ii) Any changes implemented by the department as a result of a federal program to train navigators and certified application counselors.
History: Add. 2014, Act 566, Imd. Eff. Jan. 15, 2015
Compiler's Notes: Enacting section 1 of Act 566 of 2014 provides:"Enacting section 1. (1) This amendatory act shall not be construed to do any of the following: (a) Authorize this state or an agency of this state to conduct or oversee state-level governmental consumer assistance functions for an American health benefit exchange established or operating in this state under the patient protection and affordable care act, Public Law 111-148, as amended by the health care and education reconciliation act of 2010, Public Law 111-152. (b) Convey any administrative, statutory, rule-making, or other power to this state or an agency of this state to authorize, establish, or operate an American health benefit exchange in this state that did not exist before the effective date of this amendatory act. (2) It is the intent of this legislature that any consumer assistance functions by or overseen by this state or an agency of this state with regard to an American health benefit exchange shall be conducted in a manner that utilizes and highlights Michigan-based resources, including insurance producers, in order to best serve the residents of this state and to ensure appropriate health care decisions."Enacting section 2 of Act 566 of 2014 provides:"Enacting section 2. This amendatory act applies to policies, certificates, or contracts delivered, issued for delivery, or renewed in this state on and after the effective date of this amendatory act."
Popular Name: Act 218