Opportunity Information: Apply for PR PRP 17 001
The Health Insurance Enforcement and Consumer Protections Grant Program is a discretionary grant opportunity from the Centers for Medicare and Medicaid Services (CMS), specifically through the Consumer Information and Insurance Oversight area. It is designed to help state governments carry out and strengthen enforcement of federal health insurance market reforms and consumer protections established under Part A of Title XXVII of the Public Health Service (PHS) Act. These reforms include provisions that were relatively new at the time and became effective for plan years beginning in 2014, which meant states needed practical resources to update their oversight systems and align their insurance regulatory frameworks with federal requirements.
The core purpose of the program is to provide states with funding to support implementation, planning, and operational readiness around these federal standards. In practice, this means helping states review and update their laws, regulations, policies, and administrative procedures so they match what federal law requires. The program also emphasizes states being able to effectively oversee and enforce these market reforms as they apply to health insurance issuers, which generally involves improving compliance monitoring, strengthening enforcement processes, training staff, refining consumer complaint and resolution pathways, and ensuring regulators have the capacity and tools to identify and address violations.
This opportunity is aimed solely at state governments as eligible applicants, reflecting the role states play as primary regulators of health insurance markets in many contexts. The funding instrument is a grant, and the activity category is health, with CFDA number 93.881. CMS anticipated making awards across all states and relevant jurisdictions, with an expected 51 awards, which typically corresponds to the 50 states plus the District of Columbia. The opportunity was published with a creation date of June 15, 2016, and an original application closing date of August 15, 2016. The listed award ceiling is 0, which usually indicates that a fixed maximum per award was not specified in the summary record and would instead be detailed in the full funding announcement or determined through the application and review process.
Overall, the program is essentially a capacity-building and enforcement support mechanism. It recognizes that federal market reforms and consumer protections are only as effective as the systems that administer, monitor, and enforce them. By funding state-level implementation work, CMS aimed to promote consistent compliance across insurance markets, strengthen consumer protections in day-to-day practice, and ensure state oversight operations were aligned with the federal framework governing health insurance issuers under Title XXVII Part A of the PHS Act.Apply for PR PRP 17 001
- The CMS-Consumer Information Insurance Oversight in the health sector is offering a public funding opportunity titled "The Health Insurance Enforcement and Consumer Protections Grant Program" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.881.
- This funding opportunity was created on 2016-06-15.
- Applicants must submit their applications by 2016-08-15. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The number of recipients for this funding is limited to 51 candidate(s).
- Eligible applicants include: State governments.
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Frequently Asked Questions (FAQs)
What is the Health Insurance Enforcement and Consumer Protections Grant Program?
It is a discretionary grant opportunity from the Centers for Medicare and Medicaid Services (CMS), through the Consumer Information and Insurance Oversight area, intended to help states carry out and strengthen enforcement of federal health insurance market reforms and consumer protections.
Which federal standards or reforms does this program focus on?
The program focuses on federal health insurance market reforms and consumer protections established under Part A of Title XXVII of the Public Health Service (PHS) Act, including provisions that became effective for plan years beginning in 2014.
What is the main purpose of the grant funding?
The main purpose is to provide states with funding for implementation, planning, and operational readiness related to federal market reforms and consumer protections, so state oversight systems and insurance regulatory frameworks align with federal requirements.
Who is eligible to apply for this grant?
Only state governments are eligible applicants. The opportunity is aimed solely at state governments, reflecting their role as primary regulators of health insurance markets in many contexts.
Is this grant available to local governments, nonprofits, universities, or private organizations?
No. Based on the information provided, eligibility is limited to state governments only.
What kinds of activities can grant funds support?
Funds can support state efforts to review and update laws, regulations, policies, and administrative procedures to match federal requirements, and to strengthen practical oversight and enforcement capabilities related to health insurance issuers.
How does the program help states strengthen enforcement?
The program emphasizes improving compliance monitoring, strengthening enforcement processes, training staff, refining consumer complaint and resolution pathways, and ensuring regulators have the capacity and tools to identify and address violations.
What does “consumer protections” mean in the context of this grant?
In this context, it refers to protections established under federal health insurance market reforms and the state-level systems needed to administer, monitor, and enforce those protections in day-to-day practice.
Does this program focus on state laws and regulations as well as operational systems?
Yes. The program supports states in aligning both their legal/regulatory frameworks (laws, regulations, policies) and their operational oversight systems (procedures, monitoring, enforcement, staffing, and complaint handling) with federal requirements.
What is the funding instrument for this opportunity?
The funding instrument is a grant.
What is the activity category for this grant?
The activity category is health.
What is the CFDA number associated with this program?
The CFDA number is 93.881.
How many awards were expected to be made?
CMS anticipated 51 awards, which typically corresponds to the 50 states plus the District of Columbia.
When was this funding opportunity created and when did it close?
The opportunity listed a creation date of June 15, 2016, and an original application closing date of August 15, 2016.
What does the listed award ceiling of 0 mean?
An award ceiling of 0 usually indicates that a fixed maximum per award was not specified in the summary record and would instead be detailed in the full funding announcement or determined through the application and review process.
Why was this program especially important for provisions effective in 2014?
The reforms included provisions that were relatively new at the time and became effective for plan years beginning in 2014, which meant states needed practical resources to update oversight systems and align insurance regulatory frameworks with federal requirements.
What outcomes is CMS trying to achieve through this grant program?
The program is intended to promote consistent compliance across insurance markets, strengthen consumer protections in day-to-day practice, and ensure state oversight operations are aligned with the federal framework governing health insurance issuers under Title XXVII Part A of the PHS Act.
Does the program involve oversight of health insurance issuers?
Yes. A key emphasis is helping states effectively oversee and enforce market reforms as they apply to health insurance issuers, including the ability to monitor compliance and address violations.
Is this program mainly about building capacity rather than direct consumer services?
Based on the information provided, it is primarily a capacity-building and enforcement support mechanism for state regulators, focused on implementation work, oversight readiness, and stronger enforcement systems tied to federal standards.
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