The rules also provide guidance on how states can set up a Small Business Health Options Program (SHOP), performing the basic functions of an exchange, and certifying health plans for participation in the exchange.

"States are leading the way in implementing health reform, and today's announcement builds on that momentum by giving states flexibility to design the Exchange that works for them," said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight. "This regulation allows us to meet states where they are."

HHS is accepting public comment on the proposed rules over the next 75 days, and it will hold a series of regional listening sessions and meetings.

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at or subscribe to . His e-mail address is .

in Computerworld's Health Care Topic Center.