Model QHP Addendum for Indian Health Care Providers

On April 5, 2013, the Department of Health and Human Services (HHS) released a final Letter to issuers in the Federal Marketplace.   The Letter provides essential guidance to Marketplace issuers on operational matters, and communicates key dates for the Federal Marketplace for the 2014 plan year.  This guidance may be found here.

In the letter to Issuers, CMS included information regarding the Model Qualified Health Plan (QHP) Addendum, which enables issuers to contract more efficiently with Indian health care providers to ensure that American Indians and Alaska Natives can continue to be served by their Indian provider of choice. The Model QHP Addendum will assist issuers to meet the QHP certification standards and facilitate acceptance of network contracts by I/T/U providers. CMS strongly encourages issuers and providers to use this Addendum, but use of the Model QHP Addendum is optional.    The Addendum was developed through tribal consultation and the engagement of tribal and issuer input.  You may access a copy of the Addendum here.