HHS Proposed Rule on Consumer Oriented and Operated Plans
July 2011
Proposed rule from the Department of Health and Human Services on the Consumer Oriented and Operated Plan or "CO-OP," which are designed to be private, non-profit health insurers with a "board made up of members, designed to offer quality, affordable, consumer-friendly health plans in every state," according to HHS. "The CO-OP program provides for loans to private entities with the goal to create a new CO-OP in every State to expand the number of Exchange health plans with a focus on consumer accountability. The CO-OP program contains extensive provisions to protect against fraud, waste, and abuse. Loan recipients are subject to strict monitoring, audits, and reporting requirements for the length of the loan repayment period plus 10 years. Recipients must submit semi-annual program reports and quarterly financial statements. Additionally, CMS will conduct audits, including site visits, as appropriate. CO-OPs must meet a series of milestones as laid out in their loan term agreements before drawing down any money from the program."
HHS Proposed Rule on Consumer Oriented and Operated Plans