CMS Administrator Seema Verma gives Idaho 30 days to correct the deficiencies identified in a notice this week or face a federal intervention.
The federal government has slapped down an attempt by the state of Idaho to bypass health insurance market requirements in the Affordable Care Act.
In a letter this week to Idaho Republican Gov. C.L. "Butch" Otter, Centers for Medicare & Medicaid Services Administrator Seema Verma said she was sympathetic to the state's efforts "to address the damage caused by the Patient Protection and Affordable Care Act," but warned that the Gem State's health insurance offerings violate Part A of the Public Health Services Act.
"PPACA remains the law and we have a duty to enforce and uphold the law," Verma said in the letter.
Related: Idaho 'Pushing Envelope' With Health Insurance Plan. Can It Do That?
The letter identified several noncompliance areas around pre-existing conditions, age-related premium rates, annual coverage limits, essential benefits and out-of-pocket expenses.
Verma said Idaho has 30 days to address compliance issues identified in her eight-page letter. If not, CMS could assume enforcement of the PHS Act in Idaho and impose fines or shut down noncompliant insurers.
The warning comes as the Trump administration puts forward a proposed rule to expand the availability of short-term health insurance plans, with lower premiums and stripped-down benefits.
In her letter to Otter, Verma said Idaho's market requirements could be legal under the PHS Act exception for short-term, limited-duration plans "with certain modifications."
"I encourage you to continue to engage in a dialogue with my staff regarding this and other potential options," Verma said.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.